Correlation between stroke severity and functional dependence of hospitalized patients
Original article - e235577 - Published 2024 May 12
DOI:
https://doi.org/10.33233/rbfex.v23i2.5577Keywords:
stroke, functional status, patient acuityAbstract
Introduction: Some patients suffering from a stroke have functional capacity limitations since the hospital stay. The severity of the condition may be a factor that correlates with the degree of functional dependence of these individuals. Objective: To analyze the correlation between stroke severity and the functional status of patients admitted to a reference hospital in the central-western region of Brazil. Methods: This is an analytical cross-sectional study, in which the sample was carried out by convenience. Functional status assessment was performed using the Functional Independence Measure (FIM) and Barthel scales, while stroke classification was obtained using the National Institute of Health Stroke Scale (NIHSS). Results: 68 participants were evaluated, with an average age of over 60 years. In the analyzes between the stroke severity index and the functionality measures assessed by the FIM and Barthel Index, an inverse correlation was identified (p<0.001). 48.5% of patients were classified as less severe, 42.6% as moderate, 4.4% as moderate to severe and 4.4% as severe. Regarding the assessment of functionality, evaluated by the FIM, 5.9% were classified as complete dependence, 32.4% modified dependence with assistance in up to 50% of activities, 20.6% modified dependence with assistance in up to 25% of activities. activities and 41.2% with complete/modified independence. Conclusion: The findings of the present study point to an unfavorable correlation between the degree of stroke and functionality, indicating a negative effect of increased severity on the participants' functionality.
References
Margarido AJL, Gomes AFSR, Araújo GLS, Pinheiro CM, Barreto LB. Epidemiologia do Acidente Vascular Encefálico no Brasil. Revista Eletrônica Acervo Científico. 2021;39:8859. doi: 10.25248/reac.e8859.2021
Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart Disease and Stroke Statistics—2017 Update: a report from the American Heart Association. Circulation. 2017;135(10). doi: 10.1161/cir.0000000000000485
Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart Disease and Stroke Statistics—2016 Update. Circulation. 2016;133(4). doi: 10.1161/cir.0000000000000350
Riley L, Guthold R, Cowan M, Savin S, Bhatti L, Armstrong T, et al. The World Health Organization STEPwise approach to noncommunicable disease risk-factor surveillance: methods, challenges, and opportunities. Am J Public Health. 2016;106(1):74-8. doi: 10.2105/ajph.2015.302962
Cramer SC, Sur M, Dobkin BH, O'Brien C, Sanger TD, Trojanowski JQ, et al. Harnessing neuroplasticity for clinical applications. Brain. 2011;134(6):1591-609. doi: 10.1093/brain/awr039
Fonarow GC, Saver JL, Smith EE, Broderick JP, Kleindorfer DO, Sacco RL, et al. Relationship of National Institutes of Health Stroke Scale to 30-day mortality in medicare beneficiaries with acute ischemic stroke. J Am Heart Assoc. 2012;1(111):42-50. doi: 10.1161/xjaha.111.000034
Minosso JS, Amendola F, Alvarenga MR, Oliveira MA. Validação, no Brasil, do Índice de Barthel em idosos atendidos em ambulatórios. Acta Paul Enferm. Abr 2010; 23(2):218-23. doi: 10.1590/s0103-21002010000200011
Riberto M, Miyazaki MH, Jorge Filho D, Sakamoto H, Battistella LR. Reprodutibilidade da versão brasileira da Medida de Independência Funcional. Acta Fisiatr. 2001;8(1):45-52. doi: 10.5935/0104-7795.20010002
Hoyer EH, Young DL, Klein LM, Kreif J, Shumock K, Hiser S, et al. Toward a common language for measuring patient mobility in the hospital: reliability and construct validity of interprofessional mobility measures. Phys Ther. 2017;98(2):133-42. doi: 10.1093/ptj/pzx110
Jeong M, Kang HK, Song P, Park HK, Jung H, Lee SS, et al. Hand grip strength in patients with chronic obstructive pulmonary disease. Int J Chronic Obstr Pulm Dis. 2017;12:2385-90. doi: 10.2147/copd.s140915
Jorge MSG, Ribeiro DS, Garbin K, Moreira I, Rodigheri PV, Lima WG et al. Valores de la fuerza de prensión palmar en una población de diferentes edades. Lecturas: Educación Física y Deportes [Internet]. 2019 [citado 2023 oct 12];23(249):56-69. https://efdeportes.com/efdeportes/index.php/EFDeportes/article/view/296
Jang MU, Kang J, Kim BJ, Hong JH, Yeo MJ, Han MK, et al. In-hospital and post-discharge recovery after acute ischemic stroke: a Nationwide Multicenter Stroke Registry-base Study. J Korean Med Sci. 2019;34(36):1-12. doi: 10.3346/jkms.2019.34.e240
Brandão BC, Silva MA, Rodrigues CG, Damando MD, Lourenção LG. Relação entre ingestão oral e gravidade do Acidente Vascular Cerebral Agudo. CoDAS. 2020;32(5):1-6. doi: 10.1590/2317-1782/20202018154
Bhaskar S, Stanwell P, Bivard A, Spratt N, Walker R, Kitsos G, et al. The influence of initial stroke severity on mortality, overall functional outcome and in-hospital placement at 90 days following acute ischemic stroke: A tertiary hospital stroke register study. Neurol India. 2017;65(6):1252-59. doi: 10.4103/0028-3886.217947
Tseng MC, Chang KC. Stroke severity and early recovery after first-ever ischemic stroke: Results of a hospital-based study in Taiwan. Health Policy. 2006;79(1):73-8. doi: 10.1016/j.healthpol.2005.12.003
Sakthivadivel V, Ramachandran K, Radha D, Gaur A, Kaliappan A. Is the National Institute of Health Stroke Scale a valid prognosticator of the aftermath in patients with ischemic stroke? J Fam Med Prim Care. 2022;11(11):7185-90. doi: 10.4103/jfmpc.jfmpc_611_22
Li Z, Zhang X, Wang K, Wen J. Effects of early mobilization after acute stroke: a meta-analysis of randomized control trials. J Stroke Cerebrovasc Dis. 2018;27(5):1326-37. doi: 10.1016/j.jstrokecerebrovasdis.2017.12.021
Bernhardt J, English C, Johnson L, Cumming TB. Early mobilization after stroke. Stroke. 2015;46(4):1141-6. doi: 10.1161/strokeaha.114.007434
Miranda JMA, Borges VM, Luvizutto GJ, Shinosaki JSM. Early mobilization in acute stroke phase: a systematic review. Top Stroke Rehabil. 2021;30(2):157-168. doi: 10.1080/10749357.2021.2008595
Dodds RM, Syddall HE, Cooper R, Kuh D, Cooper C, Sayer AA. Global variation in grip strength: a systematic review and meta-analysis of normative data. Age Ageing. 2016;45(2):209-16. doi: 10.1093/ageing/afv192
Diserens K, Moreira T, Hirt L, Faouzi M, Grujic J, Bieler G, et al. Early mobilization out of bed after ischaemic stroke reduces severe complications but not cerebral blood flow: a randomized controlled pilot trial. Clin Rehabil. 2011;26(5):451-9. doi: 10.1177/0269215511425541
Herisson F, Godard S, Volteau C, Le Blanc E, Guillon B, Gaudron M. Early Sitting in Ischemic Stroke Patients (SEVEL): a randomized controlled trial. PlosOne. 2016;11(3):1-13. doi: 10.1371/journal.pone.0149466
Prabhakaran S, Zarahn E, Riley C, Speizer A, Chong JY, Lazar RM, et al. Inter-individual variability in the capacity for motor recovery after ischemic stroke. Neurorehabilit Neural Repair. 2007;22(1):64-71. doi: 10.1177/1545968307305302
Einstad MS, Saltvedt I, Lydersen S, Ursin MH, Munthe-Kaas R, Ihle-Hansen H, et al. Associations between post-stroke motor and cognitive function: a cross-sectional study. BMC Geriatr. 2021;21(1):1-10. doi: 10.1186/s12877-021-02055-7
Pan B, Jin X, Jun L, Qiu S, Zheng Q, Pan M. The relationship between smoking and stroke. Medicine. 2019;98(12):1-8. doi: 10.1097/md.0000000000014872
Fischer F, Kraemer A. Meta-analysis of the association between second-hand smoke exposure and ischaemic heart diseases, COPD and stroke. BMC Public Health. 2015;15(1):1-18. doi: 10.1186/s12889-015-2489-4
Piano MR. Alcohol’s effects on the cardiovascular system. Alcohol research: current reviews [Internet].2017 [citado 2023 out];38(2):219–41. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513687/?report=classic
Briasoulis A, Agarwal V, Messerli FH. Alcohol consumption and the risk of hypertension in men and women: A Systematic Review and Meta-Analysis. J Clin Hypertens. 2012;14(11):792-8. doi: 10.1111/jch.12008
Zhang W, Pan H, Zong Y, Wang J, Xie Q. Respiratory muscle training reduces respiratory complications and improves swallowing function after stroke: A systematic review and meta-analysis. Arch Phys Med Rehabil. 2021;103(6):1179-97. doi: 10.1016/j.apmr.2021.10.020
Zhuang Z, Gao M, Yang R, Li N, Liu Z, Cao W, et al. Association of physical activity, sedentary behaviours and sleep duration with cardiovascular diseases and lipid profiles: a Mendelian randomization analysis. Lipids Health Dis. 2020;19(1):1-11. doi: 10.1186/s12944-020-01257-z
Prior PL, Suskin N. Exercise for stroke prevention. Stroke Vasc Neurol. Jun 2018;3(2):59-68. doi: 10.1136/svn-2018-000155
Sarikaya H, Ferro J, Arnold M. Stroke prevention - medical and lifestyle measures. Eur Neurol. 2015;73(3-4):150-7. doi: 10.1159/000367652
Sokol S, Kapoor J, Foody J. Blood pressure reduction in the primary and secondary prevention of stroke. Curr Vasc Pharmacol. 2006;4(2):155-60. doi: 10.2174/157016106776359862
Sila CA. Heart diseases and stroke. Curr Neurol Neurosci Rep. 2006;6(1):23-7. doi: 10.1007/s11910-996-0005-z
Hill MD. Stroke and diabetes mellitus. Handbook of Clinical Neurology. 2014;126:167–74. doi: 10.1016/B978-0-444-53480-4.00012-6
Barbaresko J, Rienks J, Nöthlings U. Lifestyle indices and cardiovascular disease risk: a meta-analysis. Am J Prev Med. 2018;55(4):555-64. doi: 10.1016/j.amepre.2018.04.046
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Copyright (c) 2024 Isadora Oliveira Freitas Barbosa, Érika Letícia Gomes Nunes, Letícia de Souza Pereira, Bruna Kelly Ferreira, Maristela Lúcia Soares Campos, Jefferson Petto, Giulliano Gardenghi
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