Potential predictors for health-related quality of life in stroke patients undergoing inpatient rehabilitation

Health and Quality of Life Outcomes

Hsieh-Ching Chen¹  Katie PH Wu²  Chia-Ling Chen⁴  Chia-Ying Chung²  Chih-Chien Tsai⁴  Chien-Min Chen³ 

[1] Department of Industrial Engineering & Management, National Taipei University of Technology, No.1, Sec. 3, Zhongxiao E. Rd., Taipei City 10608, Daan Dist., Taiwan;Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, No.5, Fushing St. , Taoyuan City 33305, Kuei-Shan Dist., Taiwan;School of Medicine, College of Medicine, Chang Gung University, Taoyuan, No.259, Wunhua 1st Rd., Taoyuan City 33302, Kuei-Shan Dist., Taiwan;Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, No.259, Wunhua 1st Rd. , Taoyuan City 33302, Kuei-Shan Dist., Taiwan

关键词: Rehabilitation;    Health-Related Quality of Life;    Predictor;    Stroke;   

Others  :  1224730
DOI  :  10.1186/s12955-015-0314-5

 received in 2015-03-18, accepted in 2015-07-24,  发布年份 2015

【 摘 要 】

Background

Improving HRQOL is the desired outcome for patients with stroke undergoing inpatient rehabilitation services. This study aimed to comprehensively identify the potential health-related quality of life (HRQOL) predictors in patients with stroke undergoing inpatient rehabilitation within the first year after stroke; thus far, such an investigation has not been conducted.

Methods

We enrolled 119 patients (88 males, 31 females) with stroke, and examined 12 potential predictors: age, sex, stroke type, stroke side, duration after onset, cognition (Mini-Mental State Examination; MMSE), depression (Beck Depression Inventory-II), stroke severity (National Institutes of Health Stroke Scale; NIHSS), upper- and lower-extremity motor function scores of the Fugl–Meyer Assessment (FMA) scale, balance (Berg Balance Scale; BBS), and functional status (Functional Independence Measure). HRQOL was measured using Stroke Impact Scale (SIS) 3.0.

Results

NIHSS score predicted the strength domain and total SIS score (41.5 % and 41.7 % of the variances, respectively). BBS score was a major predictor of mobility and participation/role domains (48.6 % and 10 % of the variances, respectively). MMSE score predicted the memory and communication domains (22.5 % and 36.3 % of the variances, respectively). Upper extremity score of the FMA scale predicted the daily living/instrumental activities of daily life and hand function domains (40.3 % and 20.6 % of the variances, respectively). Stroke side predicted the emotion domain (11.6 % of the variance).

Conclusions

NIHSS, MMSE, BBS, FMA, and stroke side predicted most HRQOL domains. These findings suggest that different factors predicted various HRQOL domains in patients with stroke.

【 授权许可】

   
2015 Chen et al.

【 参考文献 】

• [1]Lai SM, Perera S, Duncan PW, Bode R. Physical and social functioning after stroke: comparison of the Stroke Impact Scale and Short Form-36. Stroke. 2003; 34:488-93.
• [2]Coons SJ, Rao S, Keininger DL, Hays RD. A comparative review of generic quality-of-life instruments. Pharmacoeconomics. 2000; 17:13-35.
• [3]Xie J, Wu EQ, Zheng ZJ, Croft JB, Greenlund KJ, Mensah GA et al.. Impact of stroke on health-related quality of life in the noninstitutionalized population in the United States. Stroke. 2006; 37:2567-72.
• [4]Sturm JW, Donnan GA, Dewey HM, Macdonell RA, Gilligan AK, Srikanth V et al.. Quality of life after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke. 2004; 35:2340-5.
• [5]Nichols-Larsen DS, Clark PC, Zeringue A, Greenspan A, Blanton S. Factors influencing stroke survivors' quality of life during subacute recovery. Stroke. 2005; 36:1480-4.
• [6]de Haan RJ, Limburg M, Van der Meulen JH, Jacobs HM, Aaronson NK. Quality of life after stroke. Impact of stroke type and lesion location. Stroke. 1995; 26:402-8.
• [7]Shinohara Y. Factors affecting health-related quality of life assessed with the SF-36v2 health survey in outpatients with chronic-stage ischemic stroke in Japan--cross-sectional analysis of the OASIS study. Cerebrovasc Dis. 2010; 29:361-71.
• [8]Jeong BO, Kang HJ, Bae KY, Kim SW, Kim JM, Shin IS et al.. Determinants of quality of life in the acute stage following stroke. Psychiatry Investig. 2012; 9:127-33.
• [9]Gurcay E, Bal A, Cakci A. Health-related quality of life in first-ever stroke patients. Ann Saudi Med. 2009; 29:36-40.
• [10]Morris JH, van Wijck F, Joice S, Donaghy M. Predicting health related quality of life 6 months after stroke: the role of anxiety and upper limb dysfunction. Disabil Rehabil. 2013; 35:291-9.
• [11]Alguren B, Fridlund B, Cieza A, Sunnerhagen KS, Christensson L. Factors associated with health-related quality of life after stroke: a 1-year prospective cohort study. Neurorehabil Neural Repair. 2012; 26:266-74.
• [12]Franceschini M, La Porta F, Agosti M, Massucci M. Is health-related-quality of life of stroke patients influenced by neurological impairments at one year after stroke? Eur J Phys Rehabil Med. 2010; 46:389-99.
• [13]Froes KS, Valdes MT, Lopes Dde P, Silva CE. Factors associated with health-related quality of life for adults with stroke sequelae. Arq Neuropsiquiatr. 2011; 69:371-6.
• [14]Fatoye FO, Komolafe MA, Eegunranti BA, Adewuya AO, Mosaku SK, Fatoye GK. Cognitive impairment and quality of life among stroke survivors in Nigeria. Psychol Rep. 2007; 100:876-82.
• [15]Carod-Artal FJ, Coral LF, Trizotto DS, Moreira CM. The stroke impact scale 3.0: evaluation of acceptability, reliability, and validity of the Brazilian version. Stroke. 2008; 39:2477-84.
• [16]Carod-Artal FJ, Trizotto DS, Coral LF, Moreira CM. Determinants of quality of life in Brazilian stroke survivors. J Neurol Sci. 2009; 284:63-8.
• [17]Andrews K, Brocklehurst JC, Richards B, Laycock PJ. The rate of recovery from stroke - and its measurement. Int Rehabil Med. 1981; 3:155-61.
• [18]Mackenzie AE, Chang AM. Predictors of quality of life following stroke. Disabil Rehabil. 2002; 24:259-65.
• [19]Sprigg N, Gray LJ, Bath PM, Christensen H, De Deyn PP, Leys D et al.. Quality of life after ischemic stroke varies in western countries: data from the tinzaparin in Acute Ischaemic Stroke Trial (TAIST). J Stroke Cerebrovasc Dis. 2012; 21:587-93.
• [20]Owolabi MO. Consistent determinants of post-stroke health-related quality of life across diverse cultures: Berlin-Ibadan study. Acta Neurol Scand. 2013; 128:311-20.
• [21]Duncan PW, Horner RD, Reker DM, Samsa GP, Hoenig H, Hamilton B et al.. Adherence to postacute rehabilitation guidelines is associated with functional recovery in stroke. Stroke. 2002; 33:167-77.
• [22]Hopman WM, Verner J. Quality of life during and after inpatient stroke rehabilitation. Stroke. 2003; 34:801-5.
• [23]Kim S-K, Kim S-H, Jo M-W, Lee S-i. Estimation of minimally important differences in the EQ-5D and SF-6D indices and their utility in stroke. Health Qual Life Outcomes. 2015; 13:32. BioMed Central Full Text
• [24]Ghatnekar O, Eriksson M, Glader EL. Mapping health outcome measures from a stroke registry to EQ-5D weights. Health Qual Life Outcomes. 2013; 11:34. BioMed Central Full Text
• [25]Kim SH, Kim SO, Lee SI, Jo MW. Deriving a mapping algorithm for converting SF-36 scores to EQ-5D utility score in a Korean population. Health Qual Life Outcomes. 2014; 12:145. BioMed Central Full Text
• [26]Lin KC, Fu T, Wu CY, Hsieh CJ. Assessing the stroke-specific quality of life for outcome measurement in stroke rehabilitation: minimal detectable change and clinically important difference. Health Qual Life Outcomes. 2011; 9:5. BioMed Central Full Text
• [27]Hobart JC, Williams LS, Moran K, Thompson AJ. Quality of life measurement after stroke: uses and abuses of the SF-36. Stroke. 2002; 33:1348-56.
• [28]Salter KL, Moses MB, Foley NC, Teasell RW. Health-related quality of life after stroke: what are we measuring? Int J Rehabil Res. 2008; 31:111-7.
• [29]Wu CY, Yang CL, Chuang LL, Lin KC, Chen HC, Chen MD et al.. Effect of therapist-based versus robot-assisted bilateral arm training on motor control, functional performance, and quality of life after chronic stroke: a clinical trial. Phys Ther. 2012; 92:1006-16.
• [30]Lin KC, Fu T, Wu CY, Wang YH, Liu JS, Hsieh CJ et al.. Minimal detectable change and clinically important difference of the Stroke Impact Scale in stroke patients. Neurorehabil Neural Repair. 2010; 24:486-92.
• [31]Duncan PW, Bode RK, Min Lai S, Perera S. Rasch analysis of a new stroke-specific outcome scale: the Stroke Impact Scale. Arch Phys Med Rehabil. 2003; 84:950-63.
• [32]Cockrell JR, Folstein MF. Mini-Mental State Examination (MMSE). Psychopharmacol Bull. 1988; 24:689-92.
• [33]Steer RA, Ball R, Ranieri WF, Beck AT. Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients. J Clin Psychol. 1999; 55:117-28.
• [34]Brott T, Adams HP, Olinger CP, Marler JR, Barsan WG, Biller J et al.. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989; 20:864-70.
• [35]Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992; 73:1073-80.
• [36]Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975; 7:13-31.
• [37]Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. The reliability of the functional independence measure: a quantitative review. Arch Phys Med Rehabil. 1996; 77:1226-32.
• [38]Ng SS. Contribution of subjective balance confidence on functional mobility in subjects with chronic stroke. Disabil Rehabil. 2011; 33:2291-8.
• [39]Patterson SL, Forrester LW, Rodgers MM, Ryan AS, Ivey FM, Sorkin JD et al.. Determinants of walking function after stroke: differences by deficit severity. Arch Phys Med Rehabil. 2007; 88:115-9.
• [40]Kollen B, van de Port I, Lindeman E, Twisk J, Kwakkel G. Predicting improvement in gait after stroke: a longitudinal prospective study. Stroke. 2005; 36:2676-80.
• [41]Schmid AA, Van Puymbroeck M, Altenburger PA, Dierks TA, Miller KK, Damush TM et al.. Balance and balance self-efficacy are associated with activity and participation after stroke: a cross-sectional study in people with chronic stroke. Arch Phys Med Rehabil. 2012; 93:1101-7.
• [42]Patel MD, McKevitt C, Lawrence E, Rudd AG, Wolfe CD. Clinical determinants of long-term quality of life after stroke. Age Ageing. 2007; 36:316-22.
• [43]Lin KC, Fu T, Wu CY, Hsieh YW, Chen CL, Lee PC. Psychometric comparisons of the Stroke Impact Scale 3.0 and Stroke-Specific Quality of Life Scale. Qual Life Res. 2010; 19:435-43.
• [44]Kwok T, Lo RS, Wong E, Wai-Kwong T, Mok V, Kai-Sing W. Quality of life of stroke survivors: a 1-year follow-up study. Arch Phys Med Rehabil. 2006; 87:1177-82.
• [45]Rachpukdee S, Howteerakul N, Suwannapong N, Tang-Aroonsin S. Quality of life of stroke survivors: a 3-month follow-up study. J Stroke Cerebrovasc Dis. 2013; 22:e70-8.
• [46]Devinsky O. Right Cerebral Hemisphere Dominance for a Sense of Corporeal and Emotional Self. Epilepsy & Behavior. 2000; 1:60-73.
• [47]Lincoln NB, Brinkmann N, Cunningham S, Dejaeger E, De Weerdt W, Jenni W et al.. Anxiety and depression after stroke: a 5 year follow-up. Disabil Rehabil. 2013; 35:140-5.
• [48]Manimmanakorn N, Vichiansiri R, Nuntharuksa C, Permsirivanich W, Kuptniratsaikul V. Quality of life after stroke rehabilitation among urban vs. rural patients in Thailand. J Med Assoc Thai. 2008; 91:394-9.
• [49]Kwok T, Pan JH, Lo R, Song X. The influence of participation on health-related quality of life in stroke patients. Disabil Rehabil. 2011; 33:1990-6.
• [50]Carod-Artal J, Egido JA, Gonzalez JL. Varela de Seijas E. Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit. Stroke. 2000; 31:2995-3000.
• [51]Studenski S, Duncan PW, Perera S, Reker D, Lai SM, Richards L. Daily functioning and quality of life in a randomized controlled trial of therapeutic exercise for subacute stroke survivors. Stroke. 2005; 36:1764-70.