Stroke in working age: characterization of patients sent to physiotherapy

Authors

  • Carla Luzia Pimenta Departamento de Fisioterapia, Hospital Curry Cabral, Centro Hospitalar Lisboa Central. Lisboa, Portugal. Departamento das Ciências e Tecnologias de Reabilitação, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal.

DOI:

https://doi.org/10.25758/set.2191

Keywords:

Stroke, Working age, Functionality, Functional mobility, Physiotherapy

Abstract

Introduction – Stroke increases with age, however, the disability resulting from a stroke in a young and active population has a major impact on the individual and society. Aim – To analyze personal, clinical, and functional data of individuals with a stroke of working age, verifying the association between variables and comparing their results with the elderly individuals with stroke. Methods – Observational, descriptive, and cross-sectional study. The study population was individuals with strokes sent to ambulatory physiotherapy in a tertiary hospital, for a period of three years. Personal and clinical characteristics were collected; the Motor Assessment Scale (MAS) was applied and the Timed Up and Go Test (TUG) was performed. Data were analyzed through descriptive statistics, correlation analysis, and statistical inference (Chi-square test and Mann-Whitney test), considering a 95% confidence interval. Results – Of the 151 individuals evaluated, 64 were under 65 years (42.4%), including 10 under 45 (6.6%). The male gender was the most affected, and most cases were ischemic strokes. The younger ones had a better functional performance, a greater percentage of elements with autonomous gait, and better functional mobility. These differences are statistically significant when comparing the TUG results of the working-age individuals with the elderly (p=0.004) and the MAS among the under 45 years with those older than 65 (p=0.048). Most of the evaluated individuals were at risk of falling, being noticed an association between age and the risk of falls. There was a negative correlation between the MAS and TUG variables. Conclusions – With this study, due to its dimensions and limitations, it is not possible to elaborate definitive considerations about stroke in working age and its functional repercussions; however, it intends to contribute to a reflection on this theme. Physiotherapists should be aware of the specific needs of this population and adapt their intervention in order to minimize the impact of this condition on the quality of life of individuals.

Downloads

Download data is not yet available.

References

Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics – 2012 update: a report from the American Heart Association. Circulation. 2012;125(1):e2-e220.

Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197-223.

Rebelo P, editor. O essencial sobre o acidente vascular cerebral: guia prático para a população [Internet]. Lisboa: Sociedade Portuguesa do Acidente Vascular Cerebral; 2016. Available from: http://static.lvengine.net/spavc2013/Imgs/pages/PUBLICO/GUIA%20AVC%20POPULACAO_final.pdf

Griffiths D, Sturm J. Epidemiology and etiology of young stroke. Stroke Res Treat. 2011;2011:ID209370.

Zorowitz RD, Baerga E, Cuccurullo SJ. Stroke. In: Cuccurullo SJ. Physical medicine and rehabilitation board review. 3rd ed. New York: Demos Medical; 2015. p. 1-47. ISBN 9781620700396

Gomes A, Nascimento E, Matos L, Martins I, Mó M, Correia J, et al. Acidente vascular cerebral no adulto jovem: estudo prospectivo de 58 doentes [Stroke in young adults: a prospective study of 58 patients]. Med Interna. 2008;15(3):161-8. Portuguese

Cardoso T, Fonseca T, Costa M. Acidente vascular cerebral no adulto jovem [Stroke in young adults]. Acta Med Port. 2003;16(4):239-44. Portuguese

Smajlović D. Strokes in young adults: epidemiology and prevention. Vasc Health Risk Manag. 2015;11:157-64.

Henriques M, Henriques J, Jacinto J. Acidente vascular cerebral no adulto jovem: a realidade num centro de reabilitação [Young adult stroke: the reality in a rehabilitation centre]. Rev Soc Port Med Fis Reabil. 2015;27(1):9-13. Portuguese

Daniel K, Wolfe CD, Busch MA, McKevitt C. What are the social consequences of stroke for working-aged adults? A systematic review. Stroke. 2009;40(6):e431-40.

Westerlind E, Persson HC, Sunnerhagen KS. Return to work after a stroke in working age persons: a six-year follow up. PLoS One. 2017;12(1):e0169759.

Turner-Stokes L, Disler PB, Nair A, Wade DT. Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database Syst Rev. 2005;(3):CD004170.

Kissela BM, Khoury JC, Alwell K, Moomaw CJ, Woo D, Adeoye O, et al. Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology. 2012;79(17):1781-7.

Katsnelson MJ, Della-Morte D, Rundek T. Stroke in young. Period Biol. 2012;114(3):347-53.

Carr JH, Shepherd RB, Nordholm L, Lynne D. Investigation of a new motor assessment scale for stroke patients. Phys Ther. 1985;65(2):175-80.

Malouin F, Pichard L, Bonneau C, Durand A, Corriveau D. Evaluating motor recovery early after stroke: comparison of the Fugl-Meyer Assessment and the Motor Assessment Scale. Arch Phys Med Rehabil. 1994;75(11):1206-12.

Oliveira AF, Alves C, Batista P, Fernandes MB, Carolino E, Coutinho I. Contribuição para a adaptação e validação da versão portuguesa da Motor Assessment Scale [Contribution to the adaptation and validation of the Portuguese version of Motor Assessment Scale]. Saúde Tecnol. 2008;(1):25-8. Portuguese

Dean C, Mackey F. Motor assessment scale scores as a measure of rehabilitation outcome following stroke. Aust J Physiother. 1992;38(1):31-5.

Ada L, Canning C, Dean C, Moore D. Training physiotherapy students' abilities in scoring the motor assessment scale for stroke. J Allied Health. 2004;33(4):267-70.

Duncan PW, Zorowitz R, Bates B, Choi JY, Glasberg JJ, Graham GD, et al. Management of adult stroke rehabilitation care: a clinical practice guideline. Stroke. 200536(9):e100-43.

Poole JL, Whitney SL. Motor assessment scale for stroke patients: concurrent validity and interrater reliability. Arch Phys Med Rehabil. 1988;69(3 Pt 1):195-7.

Brauer SG, Bew PG, Kuys SS, Lynch MR, Morrison G. Prediction of discharge destination after stroke using the Motor Assessment Scale on admission: a prospective, multisite study. Arch Phys Med Rehabil. 2008;89(6):1061-5.

Hayward KS, Barker RN, Brauer SG, Lloyd D, Horsley SA, Carson RG. SMART arm with outcome-triggered electrical stimulation: a pilot randomized clinical trial. Top Stroke Rehabil. 2013;20(4):289-98.

Katrak PH, Black D, Peeva V. Stroke rehabilitation in Australia in a freestanding inpatient rehabilitation unit compared with a unit located in an acute care hospital. PM R. 2011;3(8):716-22.

Kwah LK, Harvey LA, Diong J, Herbert RD. Models containing age and NIHSS predict recovery of ambulation and upper limb function six months after stroke: an observational study. J Physiother. 2013;59(3):189-97.

Langhammer B, Stanghelle JK, Lindmark B. An evaluation of two different exercise regimes during the first year following stroke: a randomised controlled trial. Physiother Theory Pract. 2009;25(2):55-68.

Podsiadlo D, Richardson S. The timed ‘Up & Go’a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8.

Bonnyaud C, Pradon D, Zory R, Bensmail D, Vuillerme N, Roche N. Gait parameters predicted by Timed Up and Go performance in stroke patients. NeuroRehabilitation. 2015;36(1):73-80.

Persson CU, Danielsson A, Sunnerhagen KS, Grimby-Ekman A, Hansson PO. Timed Up & Go as a measure for longitudinal change in mobility after stroke – Postural Stroke Study in Gothenburg (POSTGOT). J Neuroeng Rehabil. 2014;11:83.

Andersson AG, Kamwendo K, Seiger A, Appelros P. How to identify potential fallers in a stroke unit: validity indexes of 4 test methods. J Rehabil Med. 2006;38(3):186-91.

Hafsteinsdóttir TB, Rensink M, Schuurmans M. Clinimetric properties of the Timed Up and Go Test for patients with stroke: a systematic review. Top Stroke Rehabil. 2014;21(3):197-210.

Hollands KL, Hollands MA, Zietz D, Wing AM, Wright C, van Vliet P. Kinematics of turning 180 degrees during the timed up and go in stroke survivors with and without falls history. Neurorehabil Neural Repair. 2010;24(4):358-67.

Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.

Barry E, Galvin R, Keogh C, Horgan F, Fahey T. 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 Geriatr. 2014;14:14.

Persson CU, Hansson PO, Sunnerhagen KS. Clinical tests performed in acute stroke identify the risk of falling during the first year: postural Stroke Study in Gothenburg (POSTGOT). J Rehabil Med. 2011;43(4):348-53.

Bowen A, James M, Young G, editors. National clinical guideline for stroke: prepared by the Intercollegiate Stroke Working Party [Internet]. 5th ed. London: Royal College of Physicians; 2016. Available from: https://www.strokeaudit.org/SupportFiles/Documents/Guidelines/2016-National-Clinical-Guideline-for-Stroke-5t-(1).aspx

Mehrholz J, Pohl M, Elsner B. Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev. 2014;(1):CD002840.

Published

2022-08-03

Issue

Section

Artigos

How to Cite

Stroke in working age: characterization of patients sent to physiotherapy. (2022). Saúde & Tecnologia, 19, 27-34. https://doi.org/10.25758/set.2191