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Body awareness therapy in persons with stroke: a pilot randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature264502
Source
Clin Rehabil. 2014 Dec;28(12):1180-8
Publication Type
Article
Date
Dec-2014
Author
Mialinn A Lindvall
Anette Forsberg
Source
Clin Rehabil. 2014 Dec;28(12):1180-8
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Humans
Kinesthesis - physiology
Male
Middle Aged
Pilot Projects
Postural Balance - physiology
Self Concept
Stroke - complications - psychology - rehabilitation
Sweden
Walking - physiology
Abstract
To investigate the effects of body awareness therapy on balance, mobility, balance confidence, and subjective health status in persons with stroke.
A pilot randomized controlled study with follow-up at one and 4-6 weeks after the intervention period.
Four primary healthcare centres in Örebro County Council.
Persons more than six months post stroke, with walking ability of 100 metres.
The experimental intervention was body awareness therapy in groups once a week for eight weeks. The controls were instructed to continue their usual daily activities.
Berg Balance Scale, Timed Up and Go Test, Timed Up and Go Test with a cognitive component, 6-minute walk test, and Timed-Stands Test. Self-rated balance confidence was assessed using the Activities-specific Balance Confidence Scale, and subjective health status using the Short Form 36 (SF-36) questionnaire.
A total of 46 participants were included (mean age 64 years); 24 in the experimental intervention group and 22 in the control group. No significant differences in changed scores over time were found between the groups. Within the experimental intervention group, significant improvements over time was found for the tests Berg Balance Scale, Timed Up and Go cognitive, and 6-minute walk test. Within the control group, significant improvements over time were found for the Timed Up and Go Cognitive, and the Timed-Stands Test.
In comparison to no intervention, no effects were seen on balance, mobility, balance confidence, and subjective health status after eight weeks of body awareness therapy.
PubMed ID
24668360 View in PubMed
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Can the Fatigue Severity Scale 7-item version be used across different patient populations as a generic fatigue measure--a comparative study using a Rasch model approach.

https://arctichealth.org/en/permalink/ahliterature257802
Source
Health Qual Life Outcomes. 2014;12:24
Publication Type
Article
Date
2014
Author
Sverker Johansson
Anders Kottorp
Kathryn A Lee
Caryl L Gay
Anners Lerdal
Author Affiliation
Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden. sverker.johansson@ki.se.
Source
Health Qual Life Outcomes. 2014;12:24
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Analysis of Variance
Chronic Disease - psychology
Fatigue - complications - diagnosis - psychology
Female
HIV Infections - complications - psychology
Humans
Male
Middle Aged
Models, Statistical
Multiple Sclerosis - complications - psychology
Psychometrics - standards
Reproducibility of Results
Severity of Illness Index
Socioeconomic Factors
Stroke - complications - psychology
Sweden
Transgendered Persons
Abstract
Fatigue is a disabling symptom associated with reduced quality of life in various populations living with chronic illnesses. The transfer of knowledge about fatigue from one group to another is crucial in both research and healthcare. Outcomes should be validly and reliably comparable between groups and should not be unduly influenced by diagnostic variations. The present study evaluates whether the Fatigue Severity Scale 7-item version (FSS-7) demonstrates similar item hierarchy across people with multiple sclerosis, stroke or HIV/AIDS to ensure valid comparisons between groups, and provide further evidence of internal scale validity.
A secondary comparative analysis was performed using data from three different studies of three different chronic illnesses: multiple sclerosis, stroke and HIV/AIDS. Each of these studies had previously concluded that the FSS-7 has better psychometric properties than the original FSS for measuring fatigue interference. Data from 224 people with multiple sclerosis, 104 people with stroke and 316 people with HIV/AIDS were examined. Item response theory and a Rasch model were chosen to analyze the similarity of the FSS-7 item hierarchy across the three diagnostic groups
Cross-sample differences were found for items #3, #5, #6 and #9 for two of the three samples, which raise questions about item validity across groups. However, disease-specific and disease-generic Rasch measures were similar across samples, indicating that individual fatigue interference measures in these three chronic illnesses might still be reliably comparable using the FSS-7.
Some items performed differently between the three samples but did not bias person measures, thereby indicating that fatigue interference in these illnesses might still be reliably compared using FSS-7 scores. However, caution is warranted when comparing fatigue raw sum scores directly across diagnostic groups using the FSS-7. Further studies of the scale are needed in other types of chronic illnesses.
Notes
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Cites: HIV Med. 2013 Apr;14(4):247-5122998022
PubMed ID
24559076 View in PubMed
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Cognitive function and improvement of balance after stroke in elderly people: the Gothenburg cognitive stroke study in the elderly.

https://arctichealth.org/en/permalink/ahliterature137202
Source
Disabil Rehabil. 2011;33(21-22):1952-62
Publication Type
Article
Date
2011
Author
Ulrika Påhlman
Cristina Gutiérrez-Pérez
Marianne Sävborg
Elvi Knopp
Elisabeth Tarkowski
Author Affiliation
The Sahlgrenska Academy, University of Gothenburg, Institution of Medicine, Gothenburg, Sweden. ulrika.pahlman@vgregion.se
Source
Disabil Rehabil. 2011;33(21-22):1952-62
Date
2011
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cognition
Cognition Disorders - complications - psychology - rehabilitation
Executive Function
Female
Follow-Up Studies
Humans
Male
Neuropsychological Tests
Postural Balance
Prospective Studies
Questionnaires
Sensation Disorders - etiology - rehabilitation
Severity of Illness Index
Socioeconomic Factors
Stroke - complications - psychology - rehabilitation
Sweden
Abstract
The ability to balance is no longer automatic after stroke in patients with motor impairment and needs to be relearned. Learning requires cognitive and executive abilities. It is well known that cognitive and executive impairments are common after stroke, but how these are related to balance has not yet been fully studied. We, therefore, wanted to explore the impact of pre-stroke cognitive impairment, global and selective cognitive and executive impairment in the early phase after stroke and at the 1-year follow-up on balance and on the improvement of balance during the first year after stroke.
Seventy-four patients were included consecutively on admission following stroke to a geriatric stroke unit and followed prospectively for 1 year. Balance was assessed using the Berg Balance Scale on admission, on discharge and 1 year after stroke.
Cognitive impairment before stroke, measured using the Cognitive Impairment Questionnaire, was found to lead to poor balance on discharge and 1 year after stroke. Patients with impaired logical deductive ability and executive function, measured using a neuropsychological test battery both in the early phase and 1 year after stroke, also had significantly poorer balance 1 year after stroke than patients with intact functions. Most importantly, only patients with intact cognitive function, before stroke, on admission and at the 1-year follow-up, significantly improved their balance after discharge.
Our results show that cognitive status, both before and after stroke, is important for balance and improvement of balance after stroke.
PubMed ID
21306194 View in PubMed
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Determinants of change in quality of life from 1 to 6 months following acute stroke.

https://arctichealth.org/en/permalink/ahliterature93898
Source
Cerebrovasc Dis. 2008;25(1-2):67-73
Publication Type
Article
Date
2008
Author
Rønning Ole Morten
Stavem Knut
Author Affiliation
Helse Øst Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway. ole.morten.ronning@ahus.no
Source
Cerebrovasc Dis. 2008;25(1-2):67-73
Date
2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Female
Follow-Up Studies
Health status
Hospitalization
Humans
Male
Norway
Outcome Assessment (Health Care)
Prospective Studies
Quality of Life
Stroke - complications - psychology - therapy
Time Factors
Abstract
BACKGROUND AND PURPOSE: Little information is available about change in health-related quality of life (HRQoL) during the first few months following acute stroke, and whether baseline variables can predict who will have the largest improvement in HRQoL. This study assessed the change in HRQoL from 1 to 6 months following acute stroke and the determinants of these changes. METHODS: Patients >60 years of age, who had experienced an acute stroke and were admitted to hospital within 24 h of onset, were followed longitudinally. HRQoL was assessed with the Short Form 36 (SF-36) health status questionnaire. RESULTS: Of 550 eligible stroke patients, 315 fulfilled the inclusion criteria and were alive after 30 days. At 1 month, 179 patients responded to the questionnaire, of whom also 140 responded at 6 months following acute stroke. From 1 to 6 months following stroke, all dimensions of the SF-36 improved. The magnitude of change was largest on the role-physical and role-emotional scales and lowest on the bodily pain and mental health scales. Higher physical component summary (PCS) score at 1 month was associated with lower odds of being above the 75th percentile of change in PCS score between the assessments, and higher baseline mental component summary (MCS) score was associated with lower odds of being above the 75th percentile of change in MCS. Treatment in a stroke unit was associated with an increase in the MCS score and higher neurological score with an increase in PCS score of the SF-36. CONCLUSION: This prospective study showed a considerable improvement in HRQoL from 1 to 6 months after stroke; however, no baseline variables except baseline scores were associated with changes in HRQoL during the 5-month period.
Notes
Comment In: Cerebrovasc Dis. 2008;26(4):453-4; author reply 45418818494
PubMed ID
18033960 View in PubMed
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Dignity realization of patients with stroke in hospital care: A grounded theory.

https://arctichealth.org/en/permalink/ahliterature300228
Source
Nurs Ethics. 2019 Mar; 26(2):378-389
Publication Type
Journal Article
Date
Mar-2019
Author
Sunna Rannikko
Minna Stolt
Riitta Suhonen
Helena Leino-Kilpi
Author Affiliation
University of Turku, Finland.
Source
Nurs Ethics. 2019 Mar; 26(2):378-389
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Ethics, Nursing
Female
Finland
Grounded Theory
Humans
Interviews as Topic - methods
Male
Middle Aged
Personhood
Qualitative Research
Quality of Health Care - ethics - standards
Stroke - complications - psychology
Abstract
Dignity is seen as an important but complex concept in the healthcare context. In this context, the discussion of dignity includes concepts of other ethical principles such as autonomy and privacy. Patients consider dignity to cover individuality, patient's feelings, communication, and the behavior of healthcare personnel. However, there is a lack of knowledge concerning the realization of patients' dignity in hospital care and the focus of the study is therefore on the realization of dignity of the vulnerable group of patients with stroke.
The aim of the study was to create a theoretical construct to describe the dignity realization of patients with stroke in hospital care.
Patients with stroke (n = 16) were interviewed in 2015 using a semi-structured interview containing open questions concerning dignity. The data were analyzed using constant comparison of Grounded Theory.
Ethical approval for the research was obtained from the Ethics Committee of the University. The permission for the research was given by the hospital. Informed consent was obtained from participants.
The "Theory of Dignity Realization of Patients with Stroke in Hospital Care" consists of a core category including generic elements of the new situation and dignity realization types. The core category was identified as "Dignity in a new situation" and the generic elements as health history, life history, individuality and stroke. Dignity of patients with stroke is realized through specific types of realization: person-related dignity type, control-related dignity type, independence-related dignity type, social-related dignity type, and care-related dignity type.
The theory has similar elements with the previous literature but the whole construct is new. The theory reveals possible special characteristics in dignity realization of patients with stroke.
For healthcare personnel, the theory provides a frame for a better understanding and recognition of how dignity of patients with stroke is realized.
PubMed ID
28659067 View in PubMed
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Experiences of participation in goal setting for people with stroke-induced aphasia in Norway. A qualitative study.

https://arctichealth.org/en/permalink/ahliterature286758
Source
Disabil Rehabil. 2017 Jun;39(11):1122-1130
Publication Type
Article
Date
Jun-2017
Author
Karianne Berg
Torunn Askim
Susan Balandin
Elizabeth Armstrong
Marit By Rise
Source
Disabil Rehabil. 2017 Jun;39(11):1122-1130
Date
Jun-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aphasia - etiology - psychology - rehabilitation
Communication
Decision Making
Female
Goals
Humans
Male
Middle Aged
Norway
Patient Participation - psychology
Qualitative Research
Stroke - complications - psychology
Stroke Rehabilitation - psychology
Abstract
The body of research into client participation in aphasia rehabilitation is increasing, but the evidence on how it is implemented into clinical practice is still scarce. Particularly, the importance of including the "insider's perspective" has been demanded. The aim of this study was to explore how people with aphasia experienced client participation during the process of goal setting and clinical decision making in language rehabilitation.
Fifteen people with stroke-induced aphasia participated in semi-structured in-depth interviews. A qualitative analysis using Systematic Text Condensation was undertaken.
Analysis revealed four main themes: (1) pleased with services, (2) vagueness in language rehabilitation, (3) personal goals exist, and (4) desired level of participation.
Even though people with stroke-induced aphasia overall are pleased with the language rehabilitation, there is a need for greater emphasis on making the framework of language rehabilitation less vague. Therapists should also spend more time on collaboration with people with stroke-induced aphasia and use available methods to support communication and collaboration. The findings underscore the need for further exploration of the potential outcomes of implementing client participation in goal setting and clinical decision making for persons with stroke-induced aphasia. Implications for rehabilitation All persons with stroke induced aphasia should be asked about their goals for rehabilitation not only once, but during the whole continuum of their rehabilitation journey. Rehabilitation professionals should place greater emphasis on client participation by asking people with stroke induced aphasia how they prefer to participate at different stages of rehabilitation. To ensure active participation for those who wants it, existing tools and techniques which promoted collaborative goal setting should be better incorporated.
PubMed ID
27293106 View in PubMed
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Fatigue in the acute phase after first stroke predicts poorer physical health 18 months later.

https://arctichealth.org/en/permalink/ahliterature106977
Source
Neurology. 2013 Oct 29;81(18):1581-7
Publication Type
Article
Date
Oct-29-2013
Author
Anners Lerdal
Caryl L Gay
Author Affiliation
From the Department of Research (A.L., C.L.G), Lovisenberg Diakonale Hospital, Oslo; the Department of Nursing Science (A.L.), Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway; the Department of Family Health Care Nursing (C.L.G.), University of California, San Francisco; and Lovisenberg Diakonale University College (C.L.G.), Oslo, Norway.
Source
Neurology. 2013 Oct 29;81(18):1581-7
Date
Oct-29-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Depression - diagnosis - etiology
Fatigue - diagnosis - etiology
Female
Follow-Up Studies
Health status
Hospitalization
Humans
Male
Middle Aged
Norway
Predictive value of tests
Psychiatric Status Rating Scales
Quality of Life
Regression Analysis
Retrospective Studies
Severity of Illness Index
Stroke - complications - psychology - radiography
Time Factors
Tomography, X-Ray Computed
Abstract
To determine whether fatigue in the acute phase following stroke predicts long-term patient-reported physical and mental health outcomes 18 months later.
Patients (n = 96, mean age 67.8 years, SD 12.9) were assessed within 2 weeks of hospital admission for first-ever stroke (acute phase) and 18 months later. Measures included the Fatigue Severity Scale and the Beck Depression Inventory II. The Short Form-36 was used to assess self-reported physical and mental health. Multivariate regression analysis was used to evaluate the relationship between acute phase fatigue and later health outcomes, controlling for relevant covariates.
Acute phase fatigue was associated with physical health at 18-month follow-up, but not with mental health. After adjusting for other potential predictors of health outcomes, including age, sex, cohabitation status, acute phase physical or mental health, and depressive symptoms, acute phase fatigue remained a significant predictor of later physical health but not of later mental health. The reverse relationships were also examined, but neither physical nor mental health in the acute phase predicted fatigue at 18 months; the best predictor of fatigue at 18-month follow-up was acute phase fatigue.
These findings suggest that acute phase fatigue is an independent risk factor for poor physical health 18 months after stroke. Diagnosis and treatment of acute phase fatigue may improve physical health-related quality of life among stroke survivors. Effective treatments for poststroke fatigue, both in the acute phase and later in the recovery period, are needed.
Notes
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Comment In: Neurology. 2013 Oct 29;81(18):1566-724078733
Comment In: Neurology. 2014 Jun 17;82(24):225524935639
PubMed ID
24078734 View in PubMed
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"Getting the Left Right": The Experience of Hemispatial Neglect After Stroke.

https://arctichealth.org/en/permalink/ahliterature279841
Source
Qual Health Res. 2015 Dec;25(12):1623-36
Publication Type
Article
Date
Dec-2015
Author
Marianne E Klinke
Dan Zahavi
Haukur Hjaltason
Björn Thorsteinsson
Helga Jónsdóttir
Source
Qual Health Res. 2015 Dec;25(12):1623-36
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Body Image - psychology
Female
Humans
Iceland
Interviews as Topic
Male
Middle Aged
Observation
Perceptual Disorders - etiology - psychology
Qualitative Research
Severity of Illness Index
Stroke - complications - psychology
Abstract
We used a phenomenological approach to gain insight into the experiences of self, other, and world in patients with hemispatial neglect within the first month following stroke. Comprehensive descriptions of circumstances were conjoined with open-ended interviews of 12 participants. The neglect experience was captured in the overarching theme, "getting the left right," which encompasses the two subthemes of (a) surreal awareness of the left and (b) emergence of a different world. Patients had unclear perceptions of their own body and surroundings, their attention was brittle, and they encountered bewildering reactions from other people. They simultaneously pursued the ineffable neglected space and searched for coherence. The vulnerability, loss, and conflicting perceptions that patients with neglect face should be acknowledged and alleviation sought. Facilitating methods should provide additional opportunities for patients to communicate their experiences. We underscore the importance of readjusting the current approaches of neglect and emphasizing meaningfulness in professional guidance.
PubMed ID
25563629 View in PubMed
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Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey.

https://arctichealth.org/en/permalink/ahliterature173617
Source
Qual Life Res. 2005 Jun;14(5):1311-20
Publication Type
Article
Date
Jun-2005
Author
Sheri L Maddigan
David H Feeny
Jeffrey A Johnson
Author Affiliation
Department of Public Health Sciences, University of Alberta, Edmonton, Canada.
Source
Qual Life Res. 2005 Jun;14(5):1311-20
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Arthritis - complications - psychology
Canada
Chronic Disease
Comorbidity
Diabetes Complications - physiopathology - psychology
Diabetes Mellitus - physiopathology - psychology
Female
Heart Diseases - complications - psychology
Humans
Male
Middle Aged
Quality of Life
Sickness Impact Profile
Stroke - complications - psychology
Abstract
To assess the impact of comorbid heart disease, stroke and arthritis on health-related quality of life (HRQL) in people with diabetes in the general Canadian population.
Data were collected as part of the 1996-1997 Canadian National Population Health Survey. HRQL was assessed using overall Health Utilities Index Mark 3 (HUI3) and single attribute utility scores. Respondents (N = 66,093) were classified into 1 of 16 groups based on the presence or absence of diabetes, heart disease, stroke, and arthritis, in all possible combinations and HRQL scores were compared using analysis of covariance.
Overall HUI3 scores for respondents with diabetes alone (0.88, 95% CI: 0.87-0.89) were lower than controls (0.92: 95% CI: 0.92-0.92, p
PubMed ID
16047506 View in PubMed
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Medical complications experienced by a cohort of stroke survivors during inpatient, tertiary-level stroke rehabilitation.

https://arctichealth.org/en/permalink/ahliterature181011
Source
Arch Phys Med Rehabil. 2004 Mar;85(3):466-9
Publication Type
Article
Date
Mar-2004
Author
Deirdre E McLean
Author Affiliation
Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada. dmclean2@dal.ca
Source
Arch Phys Med Rehabil. 2004 Mar;85(3):466-9
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Accidental Falls
Adult
Aged
Aged, 80 and over
Cohort Studies
Depression - complications
Female
Gastrointestinal Diseases - complications
Hospital Units
Hospitalization
Hospitals, Private
Humans
Male
Middle Aged
Nova Scotia
Pain - complications
Shoulder Pain - complications
Stroke - complications - psychology - rehabilitation
Urinary Tract Infections - complications
Abstract
To identify the most common medical complications experienced by stroke survivors during inpatient, tertiary-level stroke rehabilitation.
Prospective, descriptive analysis.
A tertiary-level, 23-bed, inpatient stroke rehabilitation unit in Nova Scotia, Canada.
All stroke survivors (N=133) admitted for tertiary-level stroke rehabilitation during a 1-year period.
Not applicable.
The attending physiatrist determined the presence or absence of specific complications during the interdisciplinary team conference held during the week of discharge for each patient.
The 4 most common medical complications were depression (26%), shoulder pain (24%), falls (20%), and urinary tract infection (UTI) (15%). Other less common complications included back and hip pain (5%), gastrointestinal disturbances (4%), and pneumonia (2%). Seizures, pressure ulcers, and shoulder-hand syndrome each occurred in 1.5% of the population.
Depression, shoulder pain, falls, and UTIs are common complications experienced by stroke survivors during inpatient rehabilitation. Heightened awareness of these potential complications may lead to prevention or to earlier recognition and improved management of these conditions.
PubMed ID
15031834 View in PubMed
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12 records – page 1 of 2.