Domiciliary Care Service: Factors Influencing Improvement in Activities of Daily Living Among Stroke Survivors

2019 ◽  
Vol 32 (1) ◽  
pp. 45-52
Author(s):  
Nur Raihan Ismail ◽  
Anees Abdul Hamid ◽  
Noor Aman Hamid
Keyword(s):  
Ischemic Stroke ◽  
Odds Ratio ◽  
Daily Living ◽  
Care Service ◽  
Stroke Survivors ◽  
Severe Stroke ◽  
Domiciliary Care ◽  
Factors Influencing ◽  
Home Based ◽  
Stroke Type

Stroke is a debilitating disease, adding to morbidity and mortality. Home-based rehabilitation has an influence on functional recovery among stroke survivors. This study aimed to determine factors influencing the improvement in activities of daily living (ADL) among stroke survivors after domiciliary care service. A state-wide record-review study using Domiciliary Care Record from health clinics with comprehensive domiciliary care was conducted. A logistic regression (LR) model was performed to assess factors influencing ADL improvement. Improved ADL was defined as obtaining at least 30% improvement on the Modified Barthel Index at the end of the program. From the records review, 72.2% of the participants had improved ADL following domiciliary care service. The mean age of the sample was 68.21 years ( SD = 11.99). The majority were ischemic stroke survivors (81.2%). In the single LR model, the influencing factors of ADL improvement were younger age (odds ratio [OR] = 2.76; p = .004), married (OR = 2.04; p = .018), ischemic stroke type (OR = 6.35; p < .001), less severe stroke (OR = 4.18; p < .001), no previous stroke (OR = 4.24; p < .001), and 9 to 12 home visits (OR = 2.79; p < .006). The multiple LR model showed ischemic stroke type (adjusted odds ratio [Adj. OR] = 5.30; p < .001), less severe stroke (Modified Rankin Scale score = 4; Adj. OR = 3.70; p < .001), and no previous stroke (Adj. OR = 3.51; p = .001) as significant factors when adjusted for other variables. Recognition of these factors associated with the improvement in stroke recovery is beneficial to intensify an optimal stroke care and home-based rehabilitation services.

Stroke while driving: Frequency and association with automobile accidents

2017 ◽  
Vol 13 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Joji Inamasu ◽  
Masashi Nakatsukasa ◽  
Kazuhiro Tomiyasu ◽  
Keita Mayanagi ◽  
Masaaki Nishimoto ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Intracerebral Hemorrhage ◽  
Cardiovascular Events ◽  
Altered Mental Status ◽  
Driving Frequency ◽  
Stroke Patients ◽  
Automobile Accidents ◽  
Severe Stroke ◽  
Stroke Type

Background Cardiovascular events while driving have occasionally been reported. In contrast, there have been few studies on stroke while driving. Aim The objectives of this study were to (1) report the frequency of stroke while driving and (2) evaluate its association with automobile accidents. Methods Clinical data prospectively acquired between January 2011 and December 2016 on 2145 stroke patients (1301 with ischemic stroke, 585 with intracerebral hemorrhage, and 259 with subarachnoid hemorrhage) were reviewed to identify patients who sustained a stroke while driving. The ratio of driving to performing other activities was evaluated for each stroke type. Furthermore, the drivers’ response to stroke was reviewed to understand how automobile accidents occurred. Results Among the 2145 patients, 85 (63 ischemic stroke, 20 intracerebral hemorrhage, and 2 subarachnoid hemorrhage) sustained a stroke while driving. The ratio of driving to performing other activities was significantly higher in ischemic stroke (4.8%) than in intracerebral hemorrhage (3.4%) or subarachnoid hemorrhage (0.8%). A majority of drivers either continued driving or pulled over to the roadside after suffering a stroke. However, 14 (16%) patients were involved in automobile accidents. In most patients, an altered mental status due to severe stroke was the presumed cause of the accident. Conclusion Stroke occurred while driving in 4.0% of all strokes and accidents occurred in 16% of these instances.

Factors Influencing 1-Year Medication Adherence of Korean Ischemic Stroke Survivors

2020 ◽  
Vol 27 (2) ◽  
pp. 225-234
Author(s):  
Gye-Gyoung Kim ◽  
Duck-Hee Chae ◽  
Man-Seok Park ◽  
Sung-Hee Yoo
Keyword(s):  
Ischemic Stroke ◽  
Medication Adherence ◽  
Stroke Survivors ◽  
Factors Influencing

scholarly journals Use of Oral Anticoagulation Therapy in Atrial Fibrillation after Stroke: Results from a Nationwide Registry

Thrombosis ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Stine Funder Jespersen ◽  
Louisa M. Christensen ◽  
Anders Christensen ◽  
Hanne Christensen
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulation Therapy ◽  
Stroke Patients ◽  
Related Factors ◽  
Excessive Alcohol Consumption ◽  
Severe Stroke ◽  
Oral Anticoagulation Therapy ◽  
Factors Influencing ◽  
Excessive Alcohol

Background. The knowledge is still sparse about patient related factors, influencing oral anticoagulation therapy (OAC) rates, in stroke patients with atrial fibrillation (AF). Aims. To assess the use of OAC in ischemic stroke patients diagnosed with AF and to identify patient related factors influencing the initiation of OAC. Methods. In the nationwide Danish Stroke Registry we identified 55,551 patients admitted with acute ischemic stroke from 2003 to 2011. Frequency analysis was used to assess the use of OAC in patients with AF, and logistic regression was used to determine independent predictors of OAC. Results. 17.1% () of ischemic stroke patients had AF. OAC prescription rates were increasing, and in 2011 46.6% were prescribed OAC, 42.5% had a contraindication, and 3.7% were not prescribed OAC without a stated contraindication. Younger age, less severe stroke, and male gender were positive predictors of OAC, while excessive alcohol consumption, smoking, and institutionalization were negative predictors of OAC ( values < 0.05). Conclusions. Advanced age, severe stroke, female gender, institutionalization, smoking, and excessive alcohol consumption were associated with lower OAC rates. Contraindications were generally present in patients not in therapy, and the assumed underuse of OAC may be overestimated.

scholarly journals Factors influencing adherence to home-based exercises among community-dwelling stroke survivors in India: a qualitative study

2019 ◽  
pp. 1-7 ◽  
Author(s):  
Amreen Mahmood ◽  
Pradeepa Nayak ◽  
Gerjo Kok ◽  
Coralie English ◽  
Natarajan Manikandan ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Factors Influencing ◽  
Home Based

Clinical outcomes for moderate and severe stroke survivors receiving early supported discharge: A quasi-experimental cohort study

2020 ◽  
Vol 83 (11) ◽  
pp. 680-689
Author(s):  
Kathleen Leach ◽  
Sharon Neale ◽  
Sarah Steinfort ◽  
Danielle Hitch
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Standard Treatment ◽  
Functional Independence ◽  
Control Group ◽  
Stroke Survivors ◽  
Severe Stroke ◽  
Early Supported Discharge ◽  
Significant Difference ◽  
Quasi Experimental

Introduction The aim of this study was to compare outcomes for functional independence, activities of daily living participation and balance achieved by moderate and severe stroke survivors receiving an early supported discharge model of care with those receiving standard treatment. Method A quasi-experimental cohort method was utilised, with a control group of convenience. Forty-one patients ( n = 28 early supported discharge group, n = 13 control group) who were medically stable post stroke, safe for discharge home, able to be treated in the home environment and requiring intensive rehabilitation from at least two disciplines participated. Results There was no significant difference in outcomes between early supported discharge and control groups for functional independence, activities of daily living participation or balance from baseline to 4 weeks, or 4 weeks to 8 weeks. However, patients receiving early supported discharge made further improvements across the study period, while those receiving standard care made limited improvement between 4 weeks and 8 weeks. All minimal clinically important differences on outcome measures were identified between baseline and 4 weeks. Conclusions Moderate and severe stroke survivors can achieve comparable outcomes when receiving early supported discharge or standard treatment. Early supported discharge models of care may also enhance ongoing improvement during the early phases of stroke recovery.

The Impact of Home-Based Exercise Rehabilitation on Functional Capacity in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial

2019 ◽  
Vol 32 (3) ◽  
pp. 141-147
Author(s):  
Mohammad Saadatnia ◽  
Hossein Shahnazi ◽  
Fariborz Khorvash ◽  
Fatemeh Esteki-Ghashghaei
Keyword(s):  
Randomized Controlled Trial ◽  
Ischemic Stroke ◽  
Daily Living ◽  
Controlled Trial ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Control Group ◽  
Exercise Rehabilitation ◽  
Randomized Controlled ◽  
Home Based

One of the major consequences of stroke impairments is hemiparesis, which affects activities of daily living and contributes sedentary lifestyle. The purpose of this study was evaluation of the effectiveness of home-based exercise rehabilitation incentive on daily living activities and functional capacity among acute ischemic patients. This randomized controlled trial was done from August 2017 to September 2018. Iranian subjects with unilateral ischemic stroke were recruited from inpatient wards at educational hospital. Patients were randomly assigned to the home-based rehabilitation program (intervention group) or usual care (control group). National Institute of Health Stroke Scale (NIHSS), Barthel Index Score (BI), Modified Rankin Scale (MRS), and Fugl-Meyer Upper and Lower Extremity Sensorimotor Score were evaluated in both groups at baseline and 3 months later. Intervention group received home-based rehabilitation exercise program for 3 months. Control group did not receive home-based rehabilitation program and incentive telephone call. All data were collected and analyzed by SPSS software (Version 20.0; SPSS Inc., Chicago, Illinois) using chi-square test to compare demographic variables, and independent and paired t-tests to between- and within-group assessment, respectively. Forty ischemic stroke patients (20 intervention group and 20 control group) were examined. Results showed BI, Fugl-Meyer Upper and Lower Extremity Score, and MRS score in the interventional group were significantly higher than the control group after 3-month home-based exercise rehabilitation ( p < .001). Providing a home rehabilitation program in this study resulted in a motor recovery on ischemic stroke survivors in the acute phase of recovery. This was assumed to be cost-effective intervention in low-income countries

Predictive value of the ankle brachial index in patients with acute ischemic stroke

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Konstantinos Tziomalos ◽  
Vasilios Giampatzis ◽  
Stella Bouziana ◽  
Athinodoros Pavlidis ◽  
Marianna Spanou ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Acute Ischemic Stroke ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
National Institutes Of Health ◽  
Limited Data ◽  
Severe Stroke ◽  
Hospital Outcome ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is frequently present in patients with acute ischemic stroke. However, there are limited data regarding the association between ankle brachial index (ABI) ≤ 0.90 (which is diagnostic of PAD) or > 1.40 (suggesting calcified arteries) and the severity of stroke and in-hospital outcome in this population. We aimed to evaluate these associations in patients with acute ischemic stroke. Patients and methods: We prospectively studied 342 consecutive patients admitted for acute ischemic stroke (37.4 % males, mean age 78.8 ± 6.4 years). The severity of stroke was assessed with the National Institutes of Health Stroke Scale (NIHSS)and the modified Rankin scale (mRS) at admission. The outcome was assessed with the mRS and dependency (mRS 2 - 5) at discharge and in-hospital mortality. Results: An ABI ≤ 0.90 was present in 24.6 % of the patients whereas 68.1 % had ABI 0.91 - 1.40 and 7.3 % had ABI > 1.40. At admission, the NIHSS score did not differ between the 3 groups (10.4 ± 10.6, 8.3 ± 9.3 and 9.3 ± 9.4, respectively). The mRS score was also comparable in the 3 groups (3.6 ± 1.7, 3.1 ± 1.8 and 3.5 ± 2.3, respectively). At discharge, the mRS score did not differ between the 3 groups (2.9 ± 2.2, 2.3 ± 2.1 and 2.7 ± 2.5, respectively) and dependency rates were also comparable (59.5, 47.6 and 53.3 %, respectively). In-hospital mortality was almost two-times higher in patients with ABI ≤ 0.90 than in patients with ABI 0.91 - 1.40 or > 1.40 but this difference was not significant (10.9, 6.6 and 6.3 %, respectively). Conclusions: An ABI ≤ 0.90 or > 1.40 does not appear to be associated with more severe stroke or worse in-hospital outcome in patients with acute ischemic stroke.

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