So you proved that your stroke doctors, therapists and hospital are complete failures at getting survivors recovered. WHAT ARE YOUR SOLUTIONS FOR THAT? Not 'assessments', SOLUTIONS!
Sequelae and Quality of Life in Patients Living at Home 1 Year After a Stroke Managed in Stroke Units
Sophie Broussy1,2*, 
Florence Saillour-Glenisson1,2,3, B. García-Lorenzo4, Francois Rouanet5, Emilie Lesaine1,2, Melanie Maugeais1, 
Florence Aly6, 
Bertrand Glize6, Roger Salamon1,2 and 
Igor Sibon5- 1Univ. Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France
- 2INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France
- 3CHU de Bordeaux, Pôle de Santé publique, Service d'Information Médicale, Bordeaux, France
- 4Health Technology Assessment Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
- 5Pôle des Neurosciences Cliniques, CHU Bordeaux, Bordeaux, France
- 6Physical and Rehabilitation Medicine Unit, EA4136, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France
Introduction: Knowledge about residual
deficiencies and their consequences on daily life activities among
stroke patients living at home 1-year after the initial event managed in
stroke units is poor. This multi-dimensional study assessed the types
of deficiencies, their frequency and the consequences that the specific
stroke had upon the daily life of patients.
Methods: A cross-sectional survey,
assessing, using standardized scales, 1 year post-stroke disabilities,
limitations of activities, participation and quality of life, was
carried out by telephone interview and by mail in a sample of stroke
patients who returned home after having been initially managed in a
stroke unit.
Results: A total of 161 patients were
included (142 able to answer the interview on their own; 19 needing a
care-giver). Amongst a sub-group of the patients interviewed, 55.4% (95%
Confidence Interval [47.1–63.7]) complained about pain and 60.0% (95%
CI [51.4–68.6]) complained of fatigue; about 25% presented
neuropsychological or neuropsychiatric disability. Whilst 87.3% (95% CI
[81.7–92.9]) were independent for daily life activities, participation
in every domains and quality of life scores, mainly in daily activity,
pain, and anxiety subscales, were low.
Conclusion: Despite a good 1-year
post-stroke functional outcome, non-motor disabling symptoms are
frequent amongst patients returned home and able to be interviewed,
contributing to a low level of participation and a poor quality of life.
Rehabilitation strategies focused on participation(Wrong, focus should be on getting 100% recovered. That is the doctor's responsibility to achieve that.) should be developed
to break the vicious circle of social isolation and improve quality of
life.
Introduction
Stroke is the leading cause of acquired physical
disability in adults worldwide. Although stroke units have dramatically
improved post-stroke functional outcome and reduce post-stroke mortality
(1)
by focusing on acute stroke management, they often failed to consider
stroke as a chronic disorder with potential delayed neuropsychological
and emotional consequences. Indeed, while motor impairment, spasticity
or aphasia are easily recognized complications, other deficiencies, such
as cognitive impairment (2), depression (3), or fatigue (4)
are also frequently reported but under-evaluated and poorly managed
amongst stroke survivors. These so-called “invisible” deficiencies are
thought to contribute to reduced ability to participate in daily life
activities and also impaired quality of life (5).
Furthermore, while most of patients able to return at home following
stroke managed in stroke units are supposed to have a good outcome, they
may suffer from a lack of monitoring.
Residual deficiencies and their consequences upon the
daily life activities have mainly been assessed in large and
representative populations of stroke patients (6).
However, little information is available about post-stroke sequelae in
the population of patients living at home and having been managed in
stroke units.
Moreover, most of studies assessing post-stroke sequelae
are focused on a small spectrum of sequelae; and present a high
variability of results due to heterogeneity of populations, study
designs, diagnostic scores and stroke types (4, 7, 8).
To address this lack of information, we adopted a
multi-dimensional approach to assess the frequency and type of
deficiencies with a focus on their daily-life consequences in a cohort
of patients who are living at home 1 year after stroke having managed in
stroke units.
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