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1.
Wai K. Tang Jin Y. Lu Yang K. Chen Vincent C. Mok Gabor S. Ungvari Ka S. Wong 《Archives of physical medicine and rehabilitation》2010,91(10):1511-1515
Tang WK, Lu JY, Chen YK, Mok VC, Ungvari GS, Wong KS. Is fatigue associated with short-term health-related quality of life in stroke?
Objective
To evaluate the relation between poststroke fatigue and short-term health-related quality of life (HRQOL) in Chinese patients with first or recurrent stroke.Design
Cross-sectional survey.Setting
Acute stroke unit of a general hospital.Participants
A total of 458 patients with acute ischemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong.Interventions
Not applicable.Main Outcome Measures
HRQOL was assessed with the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) at 3 months after the subjects' index stroke. Fatigue was evaluated by using the Fatigue Severity Scale (FSS). The correlation between the FSS and SF-36 scores was examined and adjusted for potential confounders, including age, sex, marital status, previous stroke, social support, global cognitive functions, neurologic deficits, and depressive symptoms.Results
Univariate analysis revealed that fatigue was a significant correlate of all SF-36 domain scores. The magnitude of correlation was highest for the vitality domain (r=−.605, Bonferroni corrected P<.05) and lowest for the physical functioning domain (r=−.202, Bonferroni corrected P<.05). Canonic correlation analysis indicated that FSS was strongly related to the HRQOL with a loading of −.678. Increasing fatigue was associated with a lower HRQOL. The association between FSS and HRQOL remained significant in the subsequent multivariate regression analysis, having adjusted for possible confounders.Conclusions
These findings suggest that fatigue has an impact on short-term HRQOL in Chinese stroke patients. The early identification and treatment of fatigue may improve HRQOL of stroke patients. 相似文献2.
Wai-Kwong Tang Chieh Grace Lau Vincent Mok Gabor S. Ungvari Ka-Sing Wong 《Archives of physical medicine and rehabilitation》2014
Objective
To examine differences in health-related quality of life (HRQOL) in stroke survivors with and without apathy.Design
Cross-sectional study.Setting
Acute stroke unit in a regional hospital.Participants
Stroke survivors (N=391) recruited from the acute stroke unit.Interventions
Not applicable.Main Outcome Measures
Participants were divided into apathy and nonapathy groups. Participants who scored ≥36 on the Apathy Evaluation Scale, clinician's version formed the apathy group. HRQOL was measured with the 2 component scores, mental component summary (MCS) and physical component summary (PCS), of the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12). Demographic and clinical information were obtained with the National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS).Results
Thirty-six (9%) participants had apathy. The apathy group had significantly lower MCS and PCS scores. After adjusting for sex, education, diabetes mellitus, and NIHSS, MMSE, GDS, and BI scores, the MCS score in the apathy group remained significantly lower.Conclusions
Apathy has a significant negative effect on HRQOL in stroke survivors, particularly on their mental health. Interventions for apathy could improve the HRQOL of stroke survivors. 相似文献3.
Lewis SJ Barugh AJ Greig CA Saunders DH Fitzsimons C Dinan-Young S Young A Mead GE 《Archives of physical medicine and rehabilitation》2011,(2):295-298
Lewis SJ, Barugh AJ, Greig CA, Saunders DH, Fitzsimons C, Dinan-Young S, Young A, Mead GE. Is fatigue after stroke associated with physical deconditioning? A cross-sectional study in ambulatory stroke survivors.
Objective
To determine the relationship between a measure of fatigue and 2 indices of physical fitness, lower limb extensor power (LLEP) and walking economy.Design
This was a cross-sectional study of patients with stroke. Fatigue was assessed by vitality (VIT) score of the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF-36v2). LLEP of the unaffected limb was measured using a lower leg extensor power rig. Walking economy was calculated by measuring oxygen consumption (mL·kg–1·m–1) during walking at a comfortable speed. Bivariate analyses were performed relating VIT to indices of fitness. Multiple regression analyses were also performed and included age, sex, and either SF-36v2 emotional role function or SF-36v2 mental health, as predictors of VIT.Setting
Community setting.Participants
Participants (N=66; 36 men; mean age ± SD, 71.0±9.9y) were all community dwelling, had survived a stroke, were able to walk independently, and had completed their stroke rehabilitation.Interventions
Not applicableMain Outcome Measures
The main outcome measure is SF-36v2 (VIT), with walking economy and LLEP of the limb unaffected by the stroke being independent variables.Results
Walking economy was not significantly related to VIT (R=–.024, P=.86, n=60). LLEP was positively related to VIT in bivariate analysis (R=.38, P=.003, n=58). After controlling for age, sex, and SF-36 emotional role function (or SF-36v2 mental health if the extreme outlier was excluded), LLEP remained a significant predictor of VIT.Conclusions
We found an association between fatigue and reduced LLEP. If a larger study confirms these findings, it would support the need to develop and test interventions to increase LLEP as a treatment for fatigue after stroke. 相似文献4.
Sophie Galanth Benoit Tressieres Annie Lannuzel Patrick Foucan Cosmin Alecu 《Archives of physical medicine and rehabilitation》2014
Objective
To evaluate functional outcome and quality of life 1 year poststroke in a Caribbean population.Design
Prospective study of patients with a first hemispheric stroke admitted consecutively between December 2010 and February 2011. The patients were evaluated (1) in the emergency department, (2) when discharged from the hospital, and (3) 1 year poststroke.Setting
A university hospital.Participants
Of the 140 consecutive patients with stroke, 78 (42% women, 24.4% hemorrhagic stroke) were included in the study.Interventions
None.Main Outcome Measures
Patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), FIM, and Medical Outcomes Study 36-Item Short-Form Health Survey.Results
The mean age of the participants was 62.1±17.7 years; 70.5% of patients had hypertension, 29.4% had diabetes, and 23.6% had chronic renal failure. At 1 year poststroke, the mortality rate was 29.4%, and the recurrence rate 2.6%. We evaluated 39 of the 55 survivors (71%). Score evolution (emergency department vs 1y later) is as follows: for the NIHSS, it was 6.2±4.9 versus 3.3±3.9 (z=−3.578; P<.001); and for the mRS score ≤2, it was 54.2% versus 66.7% (χ2=14.182; P=.25). The FIM score on discharge from the hospital versus 1 year later was 103.2±28.2 versus 101.7±31.5 (z=−1.008; P=.313). Multivariate analysis showed that aphasia, hemianopia, and incontinence significantly influenced the 1-year FIM score (P<.001). Quality of life, a patient-reported outcome measure of health-related quality of life, was significantly altered concerning vitality, role physical, and role emotional.Conclusions
One year after a first stroke, despite significant improvement of neurologic impairment, the level of dependency did not change and quality of life was altered. Aphasia, hemianopia, and incontinence significantly influenced functional state. 相似文献5.
Background
Traditional Chinese medicine (TCM) plays an important role in the primary care system in many places, but research evidence on its effectiveness is largely lacking. The aim of the present study was to compare the effectiveness between TCM and Western medicine (WM) consultations in primary care.Objectives
To evaluate whether medical consultations could improve the quality of life and health condition of patients in primary care and to find out whether there was any difference in the effectiveness bewteen TCM and WM.Design, setting and subjects
This was a prospective, longitudinal study on 290 patients of one TCM public and 841 patients of two WM general outpatient clinics (GOPC) in Hong Kong when they consulted for an episodic illness.Methods
All patients attending a TCM GOPC in TWH, and the two WM GOPC (TWH and ALC), who fullfilled the inclusion criteria were invited to participate. Each patient answered a structured questionnaire on the presenting complaint, socio-demography, chronic morbidity and service utilization, the Chinese Quality of Life instrument (ChQOL) and the SF-36V2 Health Survey immediately before and two weeks after the doctor consultation. The Global Rating on change Scale (GRS) was also administered in the week 2 assessment.Outcome measures
The primary outcomes were changes in the ChQOL and SF-36V2 HRQOL scores. Secondary outcomes included the GRS score. The significance of the change within individual were tested by paired t-tests. The differences in change in scores between WM and TCM were tested by independent sample-t-tests or chi-square, as appropriate. Multivariate regresions were used to determine the independent effect of type of medicine on the change in HRQOL scores.Results
Mean ChQOL and SF-36V2 scores of subjects improved significantly two weeks after TCM or WM consultations in all domains except for the Physical form domain of ChQOL. The greatest improvements were found in the SF-36V2 physical-health related domains. 78% TCM clinics and 71% of subjects WM clinics reported an improvement in GRS. The proportion of subjects who had improvement in HRQOL scores were lower among subjects consulting the WM clinic (72.3%) than those consulting TCM clinics (100%) but the difference was not significant after correction for baseline scores.Conclusions
Both TCM and WM consultations were associated with significant improvement in HRQOL in over 90% of patients. There was no singificant difference between the effectiveness of TCM and WM consultations. The results support the role of TCM as an alternative primary care service in Hong Kong. 相似文献6.
Barclay-Goddard R Lix LM Tate R Weinberg L Mayo NE 《Archives of physical medicine and rehabilitation》2011,92(11):1762-1769
Barclay-Goddard R, Lix LM, Tate R, Weinberg L, Mayo NE. Health-related quality of life after stroke: does response shift occur in self-perceived physical function?
Objective
To determine whether response shift (a change in the self-perceived meaning of health-related quality of life [HRQL]) was present in a model of physical function over time poststroke.Design
Secondary data analysis of a longitudinal observational study.Setting
Community.Participants
A consecutive sample of stroke survivors (N=677) at 1, 3, 6, and 12 months poststroke was included. Sixty-seven individuals were approached, but refused. Sixty-seven percent completed the study at 12 months. Mean age was 68 years; 45% of the participants were women.Interventions
Not applicable.Main Outcomes Measures
The Medical Outcomes Study 36-Item Short-Form Health Survey, Euroqol, Stroke Impact Scale, Preference-Based Stroke Index, and the Health Utilities Index.Results
Structural equation modeling was used to identify response shift. A chi-square difference test between constrained and unconstrained longitudinal models suggested the presence of response shift in the data. Reprioritization response shift, a change in relative importance of domains, was observed for physical activites. Recalibration response shift, a change in internal standards of measurement, was observed in physical activities, stairs, walking, and hand function.Conclusions
Response shift has implications for the measurement of change in physical function. Measures that focus on difficulty in task performance may be sensitive to response shift, resulting in a change in perceived HRQL over time. This has implications for choosing self-perceived or performance-based measures to detect change in physical function. 相似文献7.
Mary Egan Christopher G. Davis Claire-Jehanne Dubouloz Dorothy Kessler Lucy-Ann Kubina 《Archives of physical medicine and rehabilitation》2014
Objective
To explore reciprocal effects between participation and emotional and physical well-being during the first 2 years poststroke.Design
Prospective cohort study.Setting
Community.Participants
An inception cohort of adults (N=67) who had been discharged from an acute stroke unit or stroke rehabilitation unit after a first stroke.Interventions
Not applicable.Main Outcome Measures
Participation (Reintegration to Normal Living Index), emotional well-being (General Well-being Schedule), and physical well-being (General Self-rating of Health Question) were measured at 6, 9, 12, 18, and 24 months poststroke. Hierarchical linear modeling was used to examine the association between participation and change in well-being, controlling for sex, age, impairment (discharge FIM), and median neighborhood income.Results
Greater engagement in valued activities was significantly associated with subsequent improvement in emotional well-being. The effect of participation on change in physical well-being was marginal. Higher levels of well-being also predicted subsequent increases in participation, with emotional well-being effects moderated by income, and physical well-being effects moderated by level of impairment.Conclusions
Our results support a 2-pronged approach to addressing well-being poststroke where efforts to improve affect and boost participation are simultaneously applied. 相似文献8.
Susan J. Logtenberg Nanne Kleefstra Sebastiaan T. Houweling Klaas H. Groenier Reinold O. Gans Henk J. Bilo 《Diabetes care》2010,33(6):1169-1172
OBJECTIVE
To investigate the effects of continuous intraperitoneal insulin infusion (CIPII) compared with subcutaneous insulin on health-related quality of life (HRQOL) and treatment satisfaction, and to perform a cost analysis in type 1 diabetes.RESEARCH DESIGN AND METHODS
We used an open-label, prospective, crossover, randomized, 16-month study (N = 24). HRQOL and patient satisfaction were assessed with questionnaires (the 36-item short-form health survey [SF-36], the World Health Organization-Five Well-Being Index [WHO-5], and the Diabetes Treatment Satisfaction Questionnaire [DTSQ]). Direct costs of CIPII and continuous subcutaneous insulin infusion (CSII) were compared.RESULTS
Questionnaire scores were higher with CIPII than with subcutaneous therapy. Yearly direct pump- and procedure-associated costs for CIPII were estimated at €10,910 compared with €4,810 for CSII.CONCLUSIONS
Apart from improving glycemic control, CIPII improved HRQOL and treatment satisfaction compared with subcutaneous insulin. Direct pump- and procedure-associated costs are considerably higher for CIPII, however.We recently showed that treatment with continuous intraperitoneal insulin infusion (CIPII) compared with subcutaneous insulin results in better glycemic control, expressed as a 0.8%-point decrease in A1C (1). The aim of the current analysis was to assess the effects of CIPII on health-related quality of life (HRQOL) and treatment satisfaction compared with intensified subcutaneous insulin therapy, and to provide up-to-date cost calculations of direct pump- and procedure-associated costs. 相似文献9.
Elbaz A Debbi EM Segal G Haim A Halperin N Agar G Mor A Debi R 《Archives of physical medicine and rehabilitation》2011,(10):1618-1623
Elbaz A, Debbi EM, Segal G, Haim A, Halperin N, Agar G, Mor A, Debi R. Sex and body mass index correlate with Western Ontario and McMaster Universities Osteoarthritis Index and quality of life scores in knee osteoarthritis.
Objective
To examine the associations of sex, body mass index (BMI), and age with knee osteoarthritis (OA) symptomatic severity.Design
A cross-sectional retrospective analysis.Setting
Patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Data were acquired from a stored database of a private therapy center.Participants
Patients (N=1487) with symptomatic knee OA were evaluated.Interventions
Not applicable.Main Outcome Measures
WOMAC questionnaire and SF-36.Results
BMI correlated significantly with worse knee OA symptoms for all WOMAC and SF-36 subcategories (all P≤.001). Age correlated significantly with worse symptoms only for WOMAC function and SF-36 physical functioning (P=.001 and P=.009, respectively). A significant difference across BMI quintiles was found for all WOMAC and SF-36 subcategories (all P≤.01). Women showed worse knee OA symptoms in all WOMAC and SF-36 subcategories (all P≤.001). There was a significant interaction of sex by BMI in WOMAC pain and WOMAC function (P=.01 and P=.02, respectively).Conclusions
Based on the results of this analysis, it can be concluded that women and patients with a higher BMI with knee OA are at a greater risk for worse symptoms. 相似文献10.
Selective Serotonin Reuptake Inhibitors and Poststroke Epilepsy: A Population-Based Nationwide Study
Chien-Chen Chou Der-Jen Yen Yung-Yang Lin Yu-Chiao Wang Cheng-Li Lin Chia-Hung Kao 《Mayo Clinic proceedings. Mayo Clinic》2017,92(2):193-199
Objective
To investigate the effects of selective serotonin reuptake inhibitors (SSRIs) on poststroke epilepsy in a population-based nationwide study.Patients and Methods
The SSRI group included patients who received a stroke diagnosis from January 1, 2000, through December 31, 2009, and were prescribed SSRIs after stroke. The non-SSRI group enrolled patients with stroke who were not prescribed SSRIs from the Taiwan National Health Insurance Research Database and used propensity score matching based on the index year, duration time, sex, age, type of stroke, and duration of hospitalization. Cox proportional hazards models were used to estimate the risk of epilepsy between the SSRI and comparison groups.Results
A total of 4688 patients with stroke (2344 in each of the SSRI and non-SSRI cohorts) were enrolled. The cumulative incidence of epilepsy in the SSRI group was significantly higher than that in the comparison group (log-rank P<.001). In the SSRI group, the risk of poststroke epilepsy increased 2.45-fold (95% CI, 1.69- to 3.57-fold) compared with that in the comparison group. Furthermore, the risk of poststroke epilepsy increased with the defined daily dose of SSRIs. For patients with ischemic stroke, SSRIs users had a 2.74-fold higher risk of epilepsy than non users (95% CI, 1.79- to 4.22-fold).Conclusion
In this study, SSRI users had a higher risk of poststroke epilepsy than nonusers. Further study is warranted to investigate the causal relationship between SSRI exposure and poststroke epilepsy. 相似文献11.
12.
de Jong LD Hoonhorst MH Stuive I Dijkstra PU 《Archives of physical medicine and rehabilitation》2011,92(9):1411-1417
de Jong LD, Hoonhorst MH, Stuive I, Dijkstra PU. Arm motor control as predictor for hypertonia after stroke: a prospective cohort study.
Objectives
To analyze the development of hypertonia in the hemiparetic elbow flexors, and to explore the predictive value of arm motor control on hypertonia in a cohort of first-ever stroke survivors in the first 6 months poststroke.Design
A prospective cohort study.Setting
A cohort of stroke survivors from a large, university-affilliated hospital in The Netherlands.Participants
Patients (N=50) with first-time ischemic strokes and initial arm paralysis who were admitted to a stroke unit.Interventions
Not applicable.Main Outcome Measures
At 48 hours, 10 to 12 days, 3 and 6 months poststroke, hypertonia and arm motor control were assessed using the Modified Ashworth Scale and the Fugl-Meyer Assessment arm score.Results
The incidence rate of hypertonia reached its maximum before the third month poststroke (30%). Prevalence was 42% at 3 and 6 months. Participants with poor arm motor control at 48 hours poststroke were 13 times more likely to develop hypertonia in the first 6 months poststroke than those with moderate to good arm motor control. These results were not confounded by the amount of arm function training received.Conclusions
Hypertonia develops in a large proportion of patients with stroke, predominantly within the first 3 months poststroke. Poor arm motor control is a risk factor for the development of hypertonia. 相似文献13.
Gadidi V Katz-Leurer M Carmeli E Bornstein NM 《Archives of physical medicine and rehabilitation》2011,92(11):1802-1808
Gadidi V, Katz-Leurer M, Carmeli E, Bornstein NM. Long-term outcome poststroke: predictors of activity limitation and participation restriction.
Objectives
To describe long-term activity limitation, participation restriction, and patients' overall perception of recovery among stroke patients 4 years poststroke, and to evaluate the association between the factors. In addition, the study investigated those factors present at the time of stroke onset, which could predict the level of activity limitation and participation restriction at 4 years poststroke.Design
Prospective, 4-year follow-up study.Setting
Subjects' homes, via telephone.Participants
All first ever stroke patients (N=139) admitted to the Sheba Medical Center in Israel between February and March 2004 were followed and reassessed for activity and participation restrictions.Interventions
Not applicable.Main Outcome Measures
Barthel index (BI) (activity limitation, BI<95) and Frenchay Activities Index (FAI) (participation restriction, FAI<30). Perception of recovery was assessed by 2 simple questions.Results
At 4 years poststroke, 9 patients (6.4%) were lost to follow-up, 71 (54.1%) patients had survived; 42.3% with activity limitation, 28.2% were classified as restricted in participation, and 78.1% felt they had not completely recovered. Age at stroke onset and disability in the acute phase were the most significant predictors of activity limitation at 4 years poststroke. None of the demographic characteristics or baseline clinical features predicted participation restriction. A positive association (ρ=0.6) was noted between activity limitation and participation restriction 4 years poststroke.Conclusions
This is the first study to describe long-term outcomes poststroke in Israel. Activity limitation and participation restriction remain highly prevalent up to 4 years after stroke. The potential influence of additional factors (psychosocial, cognitive, and environmental) as predictors of participation restriction should be topics for future investigation. 相似文献14.
Relationship between quality of life and self-efficacy in persons with spinal cord injuries 总被引:1,自引:0,他引:1
Middleton J, Tran Y, Craig A. Relationship between quality of life and self-efficacy in persons with spinal cord injuries.
Objective
To study the interaction between quality of life in people with spinal cord injury (SCI) and expectations of daily living (self-efficacy) and pain.Design
Cross-sectional study with multiple independent measures.Setting
Home survey.Participants
Included 106 persons with SCI of 12 months or more in duration who were living in the community and had enrolled from past admission lists in a rehabilitation unit.Intervention
Participants received no treatments as part of the study but were asked to complete 2 questionnaires by postal survey in their postrehabilitation stage.Main Outcome Measures
The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Moorong Self-Efficacy Scale.Results
Persons with SCI were found to have lowered quality of life (QOL) compared with the Australian general population. Low self-efficacy and pain intensity were found to reduce QOL across all SF-36 domains even further. Factors such as completeness of lesion, sex, age at time of injury, and time since injury were not associated with reduced QOL. Tetraplegia was associated with lower QOL in physical functioning and greater limitation due to bodily pain. A combination of low self-efficacy and pain intensity was associated with an increased reduction in QOL compared with reductions seen for these factors by themselves.Conclusions
Rehabilitation strategies may need to concentrate on improving QOL by targeting factors like low self-efficacy. 相似文献15.
Minyoung Lee Sang Heon Lee TaeYeong Kim Hyun-Joon Yoo Sung Hoon Kim Dong-Won Suh Jaebum Son BumChul Yoon 《Archives of physical medicine and rehabilitation》2017,98(1):80-87
Objective
To explore the feasibility of a newly developed smartphone-based exercise program with an embedded self-classification algorithm for office workers with neck pain, by examining its effect on the pain intensity, functional disability, quality of life, fear avoidance, and cervical range of motion (ROM).Design
Single-group, repeated-measures design.Setting
The laboratory and participants' home and work environments.Participants
Offices workers with neck pain (N=23; mean age ± SD, 28.13±2.97y; 13 men).Intervention
Participants were classified as having 1 of 4 types of neck pain through a self-classification algorithm implemented as a smartphone application, and conducted corresponding exercise programs for 10 to 12min/d, 3d/wk, for 8 weeks.Main Outcome Measures
The visual analog scale (VAS), Neck Disability Index (NDI), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Fear-Avoidance Beliefs Questionnaire (FABQ), and cervical ROM were measured at baseline and postintervention.Results
The VAS (P<.001) and NDI score (P<.001) indicated significant improvements in pain intensity and functional disability. Quality of life showed significant improvements in the physical functioning (P=.007), bodily pain (P=.018), general health (P=.022), vitality (P=.046), and physical component scores (P=.002) of the SF-36. The FABQ, cervical ROM, and mental component score of the SF-36 showed no significant improvements.Conclusions
The smartphone-based exercise program with an embedded self-classification algorithm improves the pain intensity and perceived physical health of office workers with neck pain, although not enough to affect their mental and emotional states. 相似文献16.
Ness KK Gurney JG Zeltzer LK Leisenring W Mulrooney DA Nathan PC Robison LL Mertens AC 《Archives of physical medicine and rehabilitation》2008,89(1):128-136
Ness KK, Gurney JG, Zeltzer LK, Leisenring W, Mulrooney DA, Nathan PC, Robison LL, Mertens AC. The impact of limitations in physical, executive, and emotional function on health-related quality of life among adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
Objective
To examine associations between limitations in physical performance, executive function, and emotional health (activity domains) and either social role attainment or health-related quality of life (HRQOL) in adult survivors of childhood cancer.Design
Cross-sectional analysis.Setting
Cancer survivors living in the community; previously treated for childhood cancer at one of 26 institutions.Participants
Subjects included 7147 (76.8%) of 9307 eligible adult members of the Childhood Cancer Survivor Study who completed a follow-up questionnaire between 2002 and 2004.Interventions
Not applicable.Main Outcome Measures
Demographic information was used to classify social roles and the Medical Outcomes Survey 36-Item Short-Form Health Survey to ascertain HRQOL. Questions from the National Health Interview Survey were used to represent physical performance; from the Brief Symptom Inventory to classify emotional health; and from the Behavioral Rating of Executive Function to describe executive function. Multivariate logistic regression was used to examine the association between limitations in activity domains, role attainment, and HRQOL.Results
In this cohort, 18.1% reported deficits in physical performance, 10.5% in emotional health, and 14.0% in executive function. In adjusted models, when compared with survivors who reported no limitations, those with physical performance, executive function, or emotional health deficits were less likely to be employed, married, or have incomes greater than $20,000 a year. Limitations in executive function or emotional health were associated with no health insurance. Limitations in any activity domain were associated with poor HRQOL. Emotional health limitations had the most impact, with odds ratios from 3.18 (physical performance summary) to 25.81 (mental health).Conclusions
The results of these analyses show the need for development and testing of interventions to remediate limitations in activity domains, because they negatively impact role attainment and HRQOL. 相似文献17.
Dina Brooks Lori Davis Nada Vujovic-Zotovic Chris Boulias Farooq Ismail Denyse Richardson Roger S. Goldstein 《Archives of physical medicine and rehabilitation》2010,91(4):659-662
Brooks D, Davis L, Vujovic-Zotovic N, Boulias C, Ismail F, Richardson D, Goldstein RS. Sleep-disordered breathing in patients enrolled in an inpatient stroke rehabilitation program.
Objective
To report the prevalence of sleep-disordered breathing in an inpatient stroke rehabilitation unit and to explore correlations with functional status and health-related quality of life.Design
Cross-sectional study.Setting
Rehabilitation center.Participants
Consecutive patients (N=45; mean age, 67±12y) (28 men) enrolled in inpatient rehabilitation after ischemic (84%) or hemorrhagic stroke (16%).Interventions
Not applicable.Main Outcome Measures
Overnight respiratory polysomnography was performed on all subjects. Interviewer-administered scales of sleepiness (Epworth Sleepiness Scale) and functional status (FIM, Barthel Index) were completed. Health-related quality of life was assessed by using a general questionnaire (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]).Results
Of the 45 subjects tested, only 4 (9%) had an apnea-hypopnea index of less than 10 per hour. The mean apnea-hypopnea index was 32.2 (19.4) per hour; most events were obstructive. There was no relationship between the respiratory index and the components of SF-36 (P values>.2).Conclusions
There was a dramatically high prevalence of respiratory events in patients after stroke enrolled in an inpatient stroke rehabilitation unit. The awareness of this will influence patient evaluation and management. 相似文献18.
Gregory E. Hicks J. Megan Sions Teonette O. Velasco 《Archives of physical medicine and rehabilitation》2018,99(7):1273-1278
Objectives
To determine (1) whether there are differences in the prevalence of clinical hip symptoms between older adults with and without chronic low back pain (CLBP); and (2) whether coexisting hip symptoms are associated with worse physical performance and poorer health-related quality of life (HRQOL).Design
Case-control study.Setting
Individuals participated in a standardized evaluation in a clinical laboratory.Participants
Clinical hip symptoms, which are proposed predictors of radiographic hip osteoarthritis according to American College of Rheumatology guidelines, were evaluated in a volunteer sample of community-dwelling older adults with CLBP (n=54; aged 60–85y) and in age- and sex-matched healthy controls (n=54).Interventions
Not applicable.Main Outcome Measures
Physical performance was measured by the repeated chair rise test and stair-climbing test. HRQOL was measured by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).Results
Hip joint pain, morning stiffness, and pain with hip internal rotation were more common among older adults with CLBP (P<.05). Participants with CLBP and coexisting hip symptoms had worse physical performance than individuals without CLBP or hip symptoms (P<.0001). Additionally, the presence of coexisting hip symptoms was associated with worse HRQOL, particularly in the domains of social functioning, mental health, and role limitations attributable to emotional problems as measured by the SF-36 (P<.01).Conclusions
Given our limited understanding of CLBP among older adults, there is a definitive need to systematically explore coexisting pain conditions that may contribute to worse outcomes. Based on these data, future longitudinal studies should explore whether coexisting hip symptoms are associated with a worse prognosis in older adults with CLBP. 相似文献19.
Nicolas Nesseler Anne Defontaine Yoann Launey Jeff Morcet Yannick Mallédant Philippe Seguin 《Intensive care medicine》2013,39(5):881-888
Purpose
In septic shock, short-term outcomes are frequently reported, while long-term outcomes are not. The aim of this study was to evaluate mortality and health-related quality of life (HRQOL) in survivors 6 months after an episode of septic shock.Methods
This single-centre observational study was conducted in an intensive care unit in a university hospital. All patients with septic shock were included. Mortality was assessed 6 months after the onset of septic shock, and a comparison between patients who survived and those who died was performed. HRQOL was assessed using the MOS SF-36 questionnaire prior to hospital admission (baseline) and at 6 months in survivors. HRQOL at baseline and at 6 months were compared to the general French population, and HRQOL at baseline was compared to 6-month HRQOL.Results
Ninety-six patients were included. Six-month mortality was 45 %. Survivors were significantly younger, had significantly lower lactate levels and SAPS II scores, required less renal support, received less frequent administration of corticosteroids, and had a longer length of hospital stay. At baseline (n = 39) and 6 months (n = 46), all of the components of the SF-36 questionnaire were significantly lower than those in the general population. Compared to baseline (n = 23), the Physical Component Score (CS) improved significantly at 6 months, the Mental CS did not differ.Conclusions
Mortality 6 months after septic shock was high. HRQOL at baseline was impaired when compared to that of the general population. Although improvements were noted at 6 months, HRQOL remained lower than that in the general population. 相似文献20.
Seung-Hyun Yoon MD PhD Ueon Woo Rah MD PhD Seung Soo Sheen MD MS Kye Hee Cho MD 《Archives of physical medicine and rehabilitation》2009,90(8):1332-1339
Yoon S-H, Rah UW, Sheen SS, Cho KH. Comparison of 3 needle sizes for trigger point injection in myofascial pain syndrome of upper- and middle-trapezius muscle: a randomized controlled trial.