Longitudinal associations between stroke-related neurologic deficits and course of basic activities of daily living up to six months after stroke.

Autor:	Ribeiro Batista, Ludmilla, Silva, Silvia Lanziotti Azevedo da, Cunha Polese, Janaine, Silva, Aryane Carolina, Teixeira-Salmela, Luci Fuscaldi, Faria, Christina Danielli Coelho de Morais, Faria-Fortini, Iza
Předmět:	STROKE units REPEATED measures design RESEARCH funding CLOTHING & dress FUNCTIONAL status DESCRIPTIVE statistics NEUROLOGICAL disorders LONGITUDINAL method TRANSPORTATION WALKING ODDS ratio STROKE rehabilitation CONVALESCENCE STROKE BATHS CONFIDENCE intervals DATA analysis software ACTIVITIES of daily living TIME DEPENDENCY (Psychology) STAIR climbing DISEASE complications
Zdroj:	Disability & Rehabilitation; Dec2024, Vol. 46 Issue 24, p5838-5844, 7p
Abstrakt:	Purpose: To investigate the course of basic activities of daily living (ADL) from admission up to six months after the stroke and the longitudinal associations between stroke-related neurological deficits at admission to the stroke unit and course of basic ADL. Materials and Methods: 180 individuals with a first-ever stroke were assessed at admission to the stroke unit and at follow-ups of three and six months. Stroke-related neurological deficits were assessed at admission with the National Institutes of Stroke Scale (NIHSS). Independence in basic ADL was assessed at admission and three and six months after the stroke by the Modified Barthel Index (MBI). Generalized Estimating Equations (GEE) were performed. Results: Dependence in basic ADL reduced overtime, with most changes occurring over the first three months. Individuals, who had moderate/severe stroke-related neurological deficits (NIHSS ≥6) at admission, had higher chances of becoming more dependent in activities related to feeding (OR:1.27;95%CI = 1.03-1.55;p = 0.021), bathing (OR:1.30;95%CI = 1.11-1.50;p = 0.0005), dressing (OR:1.19;95%CI = 1.04-1.36;p = 0.010), transfers (OR:1.24;95%CI = 1.05-1.46;p = 0.0072), stair climbing (OR:1.46;95%CI = 1.27-1.66;p < 0.0001), and ambulation (OR:1.21;95%CI = 1.02-1.43;p < 0.0001). Conclusions: Decreases in dependence in basic ADL occurred mainly over three months after the stroke and showed different patterns for specific ADL. Baseline moderate/severe stroke-related neurological deficits were associated with poor functional status in basic ADL over the follow-up period. IMPLICATIONS FOR REHABILITATION: Stroke survivors experience dependence in basic activities of daily living (ADL) which is reduced over six months after the stroke and showed different individual variability in patterns of recovery. Patients with moderate/severe stroke-related neurological deficits had higher chances of becoming dependent in activities related to feeding, bathing, dressing, transfers, stair climbing, and ambulation. Rehabilitation professionals should consider assessing stroke-related neurologic deficits within the first hours after stroke, with particular attention to individuals with moderate/severe impairments. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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