Factors associated with functional disability in individuals hospitalized after stroke
DOI:
https://doi.org/10.34024/rnc.2024.v32.19226Keywords:
risk fators, stroke, Disabled PersonsAbstract
Introduction. Stroke is an important global public health problem, representing the third leading cause of death and combined disability. Goal. To analyze the factors associated with functional disability in individuals hospitalized after stroke. Method. Observational, cross-sectional study, with a convenience sample composed of individuals of both sexes, aged between 18 and 85 years, diagnosed with primary stroke, admitted to a reference hospital for stroke in the state public network, in Salvador-BA. The severity of the insult, postural control, respiratory muscle strength and functional disability were assessed using the NIHSS, PASS Scale, manovacuometry and modified Rankin Scale instruments, respectively. Correlations were performed using Spearman's coefficient and comparisons were performed using the Mann-Whitney U test. Results. The sample consisted of 35 individuals, with an average age of 58.3±14.32 years, average length of stay 21.27±14.63 days, predominantly female (54.3%), mixed race (40, 6%), married (41.2%), diagnosed with ischemic stroke (80%), carrying out some work activity prior to the event (62.3%). The reduction in MEP demonstrated a weak negative correlation with functional disability. Postural control has a moderate negative correlation, and the severity of the injury has a weak positive correlation with the inability to have autonomy in daily activities after a stroke. In the comparison between Rankin's prognostic stratifications and the variables studied, only postural control showed a difference. Conclusion. The severity of the injury and the reductions in respiratory muscle strength and postural control after stroke can have an impact on functional disability from the first weeks after the event.
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References
Campos TF, Dantas AATSG, Melo LP, Oliveira DC. Grau neurológico e funcionalidade de pacientes crônicos com acidente vascular cerebral: Implicações para a prática clínica. Arq Cienc Saúde 2014;21:28-33. https://repositorio-racs.famerp.br/racs_ol/vol-21-1/ID_558_21(1)_(Jan_Mar_2014).pdf
Estrela TLRS, Assis SC, Daltro MCSL. Avaliação da funcionalidade de pacientes com sequelas de acidente vascular cerebral através da escala de Rankin. Fisioter Bras 2018;19(5Supl):S192-9. https://doi.org/10.33233/fb.v19i5.2622
Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021;20:795–820. https://doi.org/10.1016/S1474-4422(21)00252-0
Marinho C, Monteiro M, Santos L, Oliveira-Filho J, Pinto EB. Desempenho da marcha e qualidade de vida nos sobreviventes de AVC: um estudo transversal. Rev Pesq Fisio 2018;8:79-87. https://doi.org/10.17267/2238-2704rpf.v8i1.1777
Luvizutto GJ, Santos MRL, Sartor LCA, Rodrigues JCS, Costa RDM, Braga GP, et al. Evaluation of Respiratory Muscle Strength in the Acute Phase of Stroke: The Role of Aging and Anthropometric Variables. J Stroke Cerebrovasc Dis 2017;26:2300-5. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.05.014
Carvalho-Pinto BPB, Faria CDCM. Health, function and disability in stroke patients in the community. Braz J Phys Ther 2016;20:355-66. https://doi.org/10.1590/bjpt-rbf.2014.0171
Brito RG, Lins LCRF, Almeida CDA, Neto ESR, Araújo DP, Franco CIF. Instrumentos de Avaliação Funcional Específicos Para o Acidente Vascular Cerebral. Rev Neurocienc 2013;21:593-9. https://doi.org/10.34024/rnc.2013.v21.8145
Chau JC, Thompson R, Twinn S, Chang AM, Woo J. Determinants of participation restriction among community dwelling stroke survivors: a path analysis. BMC Neurol 2009;9:49. https://doi.org/10.1186/1471-2377-9-49
Graaf JA, Van Mierlo ML, Post M WM, Achterberg WP, Kappelle LJ, Visser-Meily JMA. Long–term restrictions in participation in Stroke survivors under and over 70 year of age. Disabil Rehab 2018;40:637-45. https://doi.org/10.1080/09638288.2016.1271466
López-Espuela F, Pedrera-Zamorano JD, Jiménez-Caballero PE, Ramírez-Moreno JM, Portilla-Cuenca JC, Lavado-García JM, et al. Functional Status and Disability in Patients After Acute Stroke: A Longitudinal Study. Am J Crit Care 2016;25:144-51. https://doi.org/10.4037/ajcc2016215
Bernhardt J, Hayward KS, Kwakkel G, Ward NS, Wolf SL, Borschmann K, et al. Agreed definitions and a shared vision for new standards in stroke recovery research: the stroke recovery and rehabilitation roundtable taskforce. Int J Stroke 2017;12:444-50. https://doi.org/10.1177/1747493017711816
Costa D, Gonçalves HA, Lima LP, Ike D, Cancelliero KM, Montebelo MIL. Novos valores de referência para pressões respiratórias máximas na população brasileira. J Bras Pneumol 2010;36:306-12. https://doi.org/10.1590/S1806-37132010000300007
Yoneyama SM, Roiz RM, Oliveira TM, Oberg TD, Lima NMFV. Validação da versão brasileira da Escala de avaliação postural para pacientes após acidente vascular encefálico. Acta Fisiátr 2008;15:96-100. https://doi.org/10.11606/issn.2317-0190.v15i2a102920
Haan R, Limburg M, Bossuyt P, Meulen JVD, Aaronson N. The Clinical Meaning of Rankin ‘Handicap’ Grades After Stroke. Stroke 1995;26:2027-30. https://doi.org/10.1161/01.STR.26.11.2027
Portney LG, Watkins MP. Foundations of Clinical Research - Applications to Practice. Connecticut: Appleton & Lange; 1997. https://pdf.ebookpromotions.online/foundations-of-clinical-research-applications-to-practice.pdf
Prado PC, Poletto SR. Relação do controle de tronco com a funcionalidade em pacientes hemiparéticos após AVC. Rev Neurocienc 2021;29:1-17. https://doi.org/10.34024/rnc.2021.v29.11709
Vieira C, Fernandes S, Mimoso TP. Adaptação Cultural e Linguística e Contributo para a Validação da Escala de Avaliação Postural para Pacientes com Sequelas de AVC (PASS). Ess Fisi Online 2008;4:50-65. https://doi.org/10.12707/RIII1382
Santos RS, Dall’alba SCF, Forgiarini SGI, Rossato D, Dias AS, Junior LAF. Relationship between pulmonary function, functional independence, and trunk control in patients with stroke. Arq Neuropsiquiatr 2019;77:387-92. https://doi.org/10.1590/0004-282X20190048
Pyöriä O, Talvitie U, Nyrkkö H, Kautiainen H, Pohjolainen T. Validity of the postural control and balance for stroke test. Physiot Res Intern 2007;12:162-74. https://doi.org/10.1002/pri.376
Filha MCN, Mascarenhas L, Messias D, Dantas MC, Almeida LRS, Pinto EB, et al. Stroke Severity and Maximum Inspiratory Pressure are Independently Associated with Functional Mobility in Individuals After Stroke. J Stroke Cerebrovasc Dis 2020;29:105375. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105375
Meneghetti CHZ, Figueiredo VE, Guedes CAV, Batistela ACT. Avaliação da força muscular respiratória em indivíduos acometidos por acidente vascular cerebral. Rev Neurocienc 2011;19:56-60. https://doi.org/10.34024/rnc.2011.v19.8398
Sales RS, Moraes MA, Muniz LS, Jesus PA, Ribeiro LS, Mussi FC. Fatores associados a incapacidade funcional após acidente vascular cerebral isquêmico. Acta Paul Enferm 2024;37:eAPE00601. https://doi.org/10.37689/acta-ape/2024AO000601
Gadelha IDS, Ribeiro KSQS. Nível de severidade e capacidade funcional de sujeitos pós-AVE e o acesso à reabilitação. ConScientiae Saúde 2016;15:135-42. https://doi.org/10.5585/conssaude.v15n1.5725
Matos I, Fernandes A, Maso I, Oliveira-Filho J, Jesus PA, Fraga-Maia H, et al. Investigating predictors of community integration in individuals after stroke in a residential setting: a longitutinal study. PLoS One 2020;15:e0233015. https://doi.org/10.1371/journal.pone.0233015
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Copyright (c) 2024 Michele Carine Boneberg Deiró, Camila Keite Rodrigues Lisboa, Marilucia Reis dos Santos, Isabella Pereira Rosa de Castro, Caroline Guerreiro
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Accepted 2024-11-26
Published 2024-11-28
