Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, February 18, 2023

Patient- and proxy-perceptions on functioning after stroke rehabilitation using the 12-item WHODAS 2.0: a longitudinal cohort study

Why use this when a one simple question tells you all you need to know about stroke survivor recovery' Are you full recovered? Y/N?  Then from there your doctor and therapists get you to Yes.

Look at the WHODAS here:  APA_DSM5_WHODAS-2-Self-Administered.pdf

Patient- and proxy-perceptions on functioning after stroke rehabilitation using the 12-item WHODAS 2.0: a longitudinal cohort study


Mia Kilkki
ORCID Icon,
Minna Stolt
ORCID Icon,
Sunna Rannikko
ORCID Icon,
Miko Pasanen
ORCID Icon &
Sinikka Tarvonen-Schröder
ORCID Icon
Received 22 Dec 2021, Accepted 24 Jan 2023, Published online: 14 Feb 2023
 

Abstract

Purpose

To analyse longitudinally patient- and proxy-perceptions on stroke survivors’(SSs’) functioning using the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS) after subacute inpatient stroke rehabilitation.

Methods

Sixty-five SSs and their significant others(proxies) responded to WHODAS questionnaire at discharge and 9 to 50 months later. Self-WHODAS ratings were compared with corresponding proxy-perceptions and informal ratings on self-reported functional recovery.

Results

On average, SSs’ functioning improved after discharge, except according to self-WHODAS ratings of those with severe stroke. Individual changes were, however, notable. Association between time and change was statistically insignificant. SSs perceived greatest improvements in walking, household tasks, community life and working ability. The only items showing slight deterioration were emotions and relationships. In parallel, proxies rated all items except emotions and relationships improved. At discharge, proxies rated SSs’ functioning more impaired than SSs themselves, mostly regarding those with severe stroke. Still, inter-rater reliability was very strong and increased significantly with time (ICC 0.799 vs. 0.979 at follow-up). Ninety percent of SSs with improved functioning according to self-WHODAS reported better functioning also in the informal questionnaire.

Conclusion

WHODAS showed improvements in SSs’ functioning 9-50 months after discharge from subacute stroke rehabilitation. Improvements were in line with proxy-perception and self-reported functional recovery.

  • IMPLICATIONS FOR REHABILITATION

  • Stroke survivors’ functioning improved significantly during the 9-50 months follow-up after subacute inpatient stroke rehabilitation.

  • Stroke survivors perceived slightly less difficulties in their functioning compared to evaluations by proxies.

  • Strong correlation between patient- and proxy-perceptions on stroke survivors’ functioning strengthened from subacute to chronic phase of stroke recovery.

  • The 12-item WHODAS 2.0 seems to be a valuable patient- and proxy-reported outcome measure to assess longitudinal changes in stroke survivors’ functioning after stroke.

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