Correlation Scale, Functional Tests and Comorbidities with Episodes in Cerebrovascular Accident
Abstract
Introduction: In assessing patients with a stroke sequel, tonic and postural changes are generally evaluated, but other important information, such as functional capacity, risk of falls, and gait, should also be taken into account. Objective: To correlate the impairment level determined by Brunnstrom's scale, the results of functional tests and analyze the characteristics of the sample as being affected by comorbidities, time and number of strokes occurred. Methods: Cross-sectional evaluation of 50 patients (convenience) at a center of public rehabilitation, using Brunnstrom's scale (1-6, better limb ability closer to 6), Time Up and Go (TUG) (significant mobility deficit and in risk of falls above 20 seconds), Upright Motor Control Test (UMCT) (1-3, bellow 3 are household walkers), Step Test (ST) (disparity between member refers to slower individuals), registration of comorbidity and the time since the stroke happened and the number of episodes. Results: Grade "4" rated for upper and lower limbs by Brunnstrom's Scale, achieving over 20 seconds in TUG, level 2 in UMCT, and commitment of paretic member related to non-paretic on the ST (p<0.01). There was no influence of the time or number of strokes suffered. The main associations found were hypertension, diabetes, and dyslipidemia. Conclusion: The Brunnstrom's scale appointed moderate level function impairment for upper and lower limbs. Wherein association with functional tests determines slower and vulnerable individuals, with disability in changing the load support between members, neuromuscular control and balance deficit, fall risk and compromised walking ability.
References
Ade, E., Smith Jr, R., & Spigel, P.M. (2012). A case report: Application of the upright motor control test on physical therapy intervention of an individual follwing a stroke. Physiotherapy Theory and Practice, 28(4), 317-325. https://doi.org/10.3109/09593985.2011.608113
Andrews, A.W., Folger, S.E., Norbert, S.E., & Swift, L.C. (2008). Tests and measures used by specialist physical therapists when examining patients with stroke. Journal of Neurologic Physical Therapy, 32(3), 122-128. https://doi.org/10.1097/NPT.0b013e3181847a2f
Barry, E., Galvin, R., Keogh, C., Horgan, F., & Fahey, T. (2014). Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta- analysis. BMC Geriatrics, 14(1), 14. https://doi.org/10.1186/1471-2318-14-14
Bernhardt, J., English, C., Johnson, L., & Cumming, T.B. (2015). Early mobilization after stroke: early adoption but limited evidence. Stroke, 46(4). https://doi.org/10.1161/STROKEAHA.114.007434
Bonnyaud, C., Roche, N., Van Hamme, A., Bensmail, D., & Pradon, D. (2016). Locomotor trajectories of stroke patients during oriented gait and turning. PLoS ONE, 11(2), e0149757. https://doi.org/10.1371/journal.pone.0149757
Bouchalová, V., Houben, E., Tancsik, D., Schaekers, L., Meuws, L., & Feys, P. (2016). The influence of an ankle-foot orthosis on the spatiotemporal gait parameters and functional balance in chronic stroke patients. Journal of Physical Therapy Science, 28(5), 1621-1628. https://doi.org/10.1589/jpts.28.1621
Chung, M.M.L., Chan, R.W.Y., Fung, Y.K., Fong, S.S.M., Lam, S.S.L., Lai, C.W.K., & Ng, S.S.M. (2014). Reliability and validity of alternate step test times in subjects with chronic stroke. Journal of Rehabilitation Medicine, 46(10), 969-974. https://doi.org/10.2340/16501977-1877
Clarke, C.L., Holdsworth, R.J., Ryan, C.G., & Granat, M.H. (2013). Free-living physical activity as a novel outcome measure in patients with intermittent claudication. European Journal of Vascular and Endovascular Surgery, 45(2), 162-167. https://doi.org/10.1016/j.ejvs.2012.11.027
Cohen, J.W., Ivanova, T.D., Brouwer, B., Miller, K.J., Bryant, D., & Garland, S.J. (2018). Do Performance Measures of Strength, Balance, and Mobility Predict Quality of Life and Community Reintegration After Stroke? Archives of Physical Medicine and Rehabilitation, 99(4), 713-719. https://doi.org/10.1016/j.apmr.2017.12.007
Ferri, C.P., Buehler, A., Flato, U.A.P., Puglia Junior, P., & Fernandes, J.G. (2016). Endovascular thrombectomy for the treatment of acute ischemic stroke. Arquivos de Neuropsiquiatria, 74(1), 67-74. https://doi.org/10.1590/0004-282X20150182
Gschwind, Y.J., Kressig, R.W., Lacroix, A., Muehlbauer, T., Pfenninger, B., & Granacher, U. (2013). A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: Study protocol for a randomized controlled trial. BMC Geriatrics, 13(1), 105. https://doi.org/10.1186/1471-2318-13-105
Gupta, A., Giambrone, AE, Gialdini, G., Finn, C., Delgado, D., Gutierrez, J., Wright, C., Beiser, AS, Seshadri, S., Pandya, A., & Kamel, H. (2016). Silent brain infarction and risk of future stroke: a systematic review and meta-analysis. Stroke, 47(3), 719-725. https://doi.org/10.1161/STROKEAHA.115.011889
Jang, SH, Yi, JH, Chang, CH, Jung, YJ, Kim, SH, Lee, J., & Seo, JP (2016). Prediction of motor outcome by shoulder subluxation at early stage of stroke. Medicine, 95(32), e4525. https://doi.org/10.1097/MD.0000000000004525
Joa, KL, Kwon, S., Choi, JW, Hong, SE, Kim, CH, Jung, H., Berg, K., & Impact, CR (2015). Classification of walking ability of household walkers versus community walkers based on K-BBS, gait velocity and upright motor control. European Journal of Physical and Rehabilitation Medicine, 51(5), 619-625. https://www.researchgate.net/publication/266944612
Jönsson, AC, Delavaran, H., Lövkvist, H., Baturova, M., Iwarsson, S., Norrving, ASB, & Lindgren, A. (2018). Secondary prevention and lifestyle indices after stroke in a long- term perspective. Acta Neurologica Scandinavica, 138(3), 227-234. https://doi.org/10.1111/ane.12944
Karuka, A.H., Silva, J.A.M.G., & Navega, M.T. (2011). Analysis of agreement of assessment tools of body balance in the elderly. Revista Brasileira de Fisioterapia, 15(6), 460-466. http://dx.doi.org/10.1590/S1413-35552011000600006
Kuster, GW, Dutra, LA, Brasil, IP, Pacheco, EP, Arruda, MJC, Volcov, C., & Domingues, RB (2016). Performance of four ischemic stroke prognostic scores in a Brazilian population. Arquivos de Neuro-Psiquiatria, 74(2), 133-137. https://doi.org/10.1590/0004-282X20160002
Lim, Y.-H., Choi, E.-H., & Lim, J.Y. (2016). Comparison of effects of botulinum toxin injection between subacute and chronic stroke patients: a pilot study. Medicine, 95(7), e2851. https://doi.org/10.1097/MD.0000000000002851
Lima, K.C.S. de, Piauilino, P.M.M., Franco, R.M., & Silva, R.S.D.L. (2016). Efeito do alongamento muscular, mobilização neural e estimulação vibratória em pacientes com AVE. ConScientiae Saúde, 15(1), 62-70. https://doi.org/10.5585/conssaude.v15n1.5861
Lotufo, PA, Goulart, AC, De Azeredo Passos, VM, Satake, FM, de Souza, MDFM, França, EB, Ribeiro, ALP, & Bensenõr, IJM (2017). Cerebrovascular disease in Brazil from 1990 to 2015: Global Burden of Disease 2015. Revista Brasileira de Epidemiologia, 20(Suppl. 01), 129-141. https://doi.org/10.1590/1980-5497201700050011
Maeda, N., Urabe, Y., Murakami, M., Itotani, K., & Kato, J. (2015). Discriminant analysis for predictor of falls in stroke patients by using the berg balance scale. Singapore Medical Journal, 56(5), 280-283. https://doi.org/10.11622/smedj.2015033
Maguire, C.C., Sieben, J.M., & de Bie, R.A. (2016). The influence of walking-aids on the plasticity of spinal interneuronal networks, central-pattern-generators and the recovery of gait post-stroke. A literature review and scholarly discussion. Journal of Bodywork and Movement Therapies, 21(2), 422-434. https://doi.org/10.1016/j.jbmt.2016.09.012
Maguire, C., Sieben, JM, Erzer, F., Goepfert, B., Frank, M., Ferber, G., Jehn, M., Schmidt-Trucksäss, A., & de Bie, RA (2012). How to improve walking, balance and social participation following stroke: a comparison of the long term effects of two walking aids--canes and an orthosis TheraTogs--on the recovery of gait following acute stroke. A study protocol for a multi-centre, sin. BMC Neurology, 12(1), 18. https://doi.org/10.1186/1471-2377-12-18
Martins, SCO, Pontes-Neto, OM, Alves, CV, de Freitas, GR, Filho, JO, Tosta, ED, & Cabral, NL (2013). Past, present, and future of stroke in middle-income countries: the Brazilian experience. International Journal of Stroke: Official Journal of the International Stroke Society, 8 Suppl A1(6), 106-111. https://doi.org/10.1111/ijs.12062
Mercer, V.S., Freburger, J.K., Chang, S.-H., & Purser, J.L. (2009). Step Test scores are related to measures of activity and participation in the first 6 months after stroke. Physical Therapy, 89(10), 1061-1071. https://doi.org/10.2522/ptj.20080368
Naki, I.K., Rodrigues, T.A., Andrade, T.S. De, Esotico, A.P.D.C.A., Heyn, D., Imamura, M., & Battistella, L.R. (2012). Acute encephalic vascular accident: rehabilitation. Acta Fisiátrica, 19(2), 60-65. https://doi.org/10.5935/0104-7795.20120012
Pennati, G.V., Plantin, J., Borg, J., & Lindberg, P.G. (2016). Normative NeuroFlexor data for detection of spasticity after stroke: a cross-sectional study. Journal of Neuroengineering and Rehabilitation, 13, 30. https://doi.org/10.1186/s12984-016-0133-x
Reisman, DS, Kesar, TM, Perumal, R., Roos, MA, Rudolph, KS, Higginson, J., Helm, E., & Binder-Macleod, S. (2013). Time course of functional and biomechanical improvements during a gait training intervention in persons with chronic stroke. Journal of Neurologic Physical Therapy, 37(4), 159-165. https://doi.org/10.1097/NPT.0000000000000020
Santos, D.G. dos, Pegoraro, A.S.N., Abrantes, C.V., Jakaitis, F., Gusman, S., & Bifulco, S.C. (2011). Evaluation of functional mobility of patients with stroke sequela after treatment in hydrotherapy pool using the Timed Up and Go Test. Einstein, 9(11), 302-306. https://doi.org/10.1590/S1679-45082011AO1772
Srimath, S., Konduru, T., Ranjan, A., Bollisetty, A., & Yadla, V. (2018). Assessment of risk factors influencing functional outcomes in cerebral stroke patients using modified. 7(3), 755-769. https://doi.org/10.20959/wjpps20183-11072
Sütbeyaz, S., Yavuzer, G., Sezer, N., & Koseoglu, B.F. (2007). Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 88(5), 555-559. https://doi.org/10.1016/j.apmr.2007.02.034
Terranova, TT, Albieri, FO, Almeida, MD, Ayres, DVM, Cruz, SF, Milazzotto, MV, Tsukimoto, DR, Imamura, M., & Battistella, LR (2012). Chronic cerebral vascular accident: rehabilitation. Acta Fisiátrica, 19(2), 50-59. https://doi.org/10.5935/0104-7795.20120011
Vidoni, E.D., Mattlage, A., Mahnken, J., Burns, J.M., Donough, J.M., & Billinger, S.A. (2013). Validity of the Step Test for exercise prescription does not extend to a larger age range. J Aging Phys Act, 21(4), 444-454. http://dx.doi.org/10.1123/japa.21.4.444
Wevers, L., Van De Port, I., Vermue, M., Mead, G., & Kwakkel, G. (2009). Effects of task-oriented circuit class training on walking competency after stroke: A systematic review. Stroke, 40(7), 2450-2459. https://doi.org/10.1161/STROKEAHA.108.541946
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