A cohort study on anxiety and perceived recovery 3 and 12 months after mild to moderate stroke

Yeah, we know about post stroke depression and anxiety. WHY THE FUCK AREN'T YOU SOLVING THE PROBLEM?

Post stroke depression(33% chance).

Post stroke anxiety(20% chance). 

 

Why are you not solving the primary cause of anxiety? Lack of 100% recovery protocols! Solve the primary problem and you don't need to work on secondary problems. DO YOU NOT UNDERSTAND?

Solve the fucking problem, don't just tell us it exists! We've known that for years.   I'd fire everyone involved in this crapola!

A cohort study on anxiety and perceived recovery 3 and 12 months after mild to moderate stroke

Linda Nelsone^1,2 Lena Rafsten^3,4* Tamar Abzhandadze^3,4 Katharina S. Sunnerhagen^3,5

• ¹Faculty of Residency, Riga Stradins University, Riga, Latvia
• ²Riga East University Hospital, Riga, Latvia
• ³Department of Clinical Neuroscience and Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
• ⁴Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
• ⁵Rehabilitation Medicine, Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden

Background: Anxiety is a common complication of stroke, affecting one in every three stroke survivors. Stroke recovery is a dynamic process, with most recovery occurring within the first 3 months. However, how anxiety affects this dynamic remains unknown. Therefore, this study aimed to investigate how anxiety affects perceived recovery at 3 and 12 months after stroke. Additionally we also examined the change in perceived stroke recovery from 3 to 12 months and its relationship with anxiety.

Methods: In this longitudinal study patients with stroke were enrolled at Sahlgrenska University Hospital, Gothenburg, Sweden. The Hospital Anxiety and Depression Scale was used to assess anxiety, and the Stroke Impact Scale was used to assess perceived recovery 3 and 12 months after the stroke. The difference in perceived stroke recovery between the anxiety and no-anxiety groups at 3 and 12 months was analyzed. Changes in perceived stroke recovery were calculated and trichotomized from 3 to 12 months based on clinically significant positive changes (+10 points or more), clinically important negative changes (−10 points or less), or no changes (±9). At 3 and 12 months after the stroke, negative and positive recovery was compared to no change in recovery regarding anxiety scores.

Results: This study included 99 patients (44.4% female, median age, 77 years). At 3 and 12 months after the stroke, the median recovery score was 80 out of 100. At 3- and 12-months 17.6 and 15.7% of the patients experienced anxiety, respectively. At both time points, there was a significant association between anxiety and lower perceived stroke recovery (at 3 months: p < 0.001; and 12 months p = 0.002). Among participants with anxiety at 3 or 12 months after stroke, a positive change in recovery from 3 to 12 months was identified (3 months, p = 0.004 and 12 months, p = 0.0014).

Conclusion: Anxiety symptoms following a stroke are associated with lower levels of perceived(What were actual levels of recovery? If not done then the research was incompetent.) stroke recovery for at least 1 year after the stroke. Identifying patients with anxiety early after stroke may be beneficial for identifying those at risk of lower recovery.

Clinical trial registration:ClinicalTrials.gov, identifier [NCT01622205]. Registered on June 19, 2012 (retrospectively registered).

Introduction

Stroke is a sudden neurological deficit caused by acute cerebrovascular, ischemic, or hemorrhagic focal damage (1). In 2019, the incidence of stroke was 12 million, with a global prevalence of 101 million (2), making it the third leading cause of disability and death worldwide (2). More people survive strokes, increasing the likelihood of living with long-term physical, cognitive, and psychological consequences (2, 3).

Psychological consequences of stroke can contribute to poor outcomes (4–7). Anxiety is the second most common neuropsychiatric consequence of stroke (8), affecting approximately 20–30% of stroke survivors at some point after the stroke (9, 10). According to the World Health Organization, approximately 38% of the general population experience some form of anxiety (11). A longitudinal study concluded that anxiety levels did not change significantly during the first year after stroke (12). Anxiety can be defined as a feeling of worry, uneasiness, fear, or dread (13). Anxiety after a stroke is associated with a reduced quality of life, increased disability, depression, and dependency on activities of daily living (7, 10, 14–17).

Other common stroke consequences include impaired motor and sensory functions, cognitive function, participation restrictions, and daily activity limitations (18). Patients with stroke-related impairments undergo the most intensive recovery during the first 3 months and continue for at least 1 year after the stroke (19). However, patients perceive their improvement differently, and all stroke consequences can be related to how they perceive their recovery. Longitudinal changes in perceived recovery have been investigated, and significant improvements have been found between 3 and 12 months after stroke (20). Perceived recovery can be defined as the subjective perception of a patient’s physical and psychological improvement (21). The Stroke Impact Scale (SIS) is a common used tool to assess how patients with stroke perceive recovery. It was developed to assess the perceptions of patients on the impact of stroke on dimensions such as emotion, communication, memory, thinking, social role, and perceived global stroke recovery (22).

Individually, studies have been conducted on post-stroke anxiety and perceived stroke recovery. Anxiety is a common condition following stroke (9, 10) and is associated with a reduced quality of life (23). Furthermore, the tool of perceived stroke recovery is used to assess the subjective thoughts of patients about their recovery process (21). However, the role of anxiety in stroke recovery is unknown, necessitating further research in this field.

Hence, this study aimed to investigate the association between anxiety and perceived recovery at 3 and 12 months after stroke. Furthermore, this study aimed to investigate the change in perceived stroke recovery from 3 to 12 months and its relationship with anxiety.

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