Research Article

Functional Performance and Community Reintegration of Chronic Post-Stroke Survivors in Eastern India

Abstract

Introduction: Stroke is the primary cause of functional dependency in daily activities leading to disability of the individual. It becomes an economic burden for the person and society. Post-stroke management in rehabilitation gives more emphasis on improving functional performance. The improvement in functional activities of post-stroke survivors makes them independent in their daily activities at home but, still an impediment exists to participate in society and reintegrating into the community. The objective of the study is to find the association of community reintegration with the functional performance of one-year post-stroke survivors in eastern India and to compare their functional independence, community reintegration, and participation in instrumental daily living activities between stroke affection side and stroke subtype of the study group.
Materials and Methods: A cross-sectional observational study was carried out on post-stroke survivors between 30 and 60 years of age without sex barrier. Ninety-four patients (mean age 54.38±12.06) were recruited for the study. The outcome was measured by the community integration questionnaire (CIQ), Lawton instrumental activities of daily living (LIADL), and functional independence measure (FIM).
Results: Spearman rank order correlation was used and found a significant positive correlation persists between FIM to CIQ as the r=0.565 (P=0.01, 95% CI, -0.40%-0.70%) and LIADL to CIQ r=0.687 (P=0.01, 95% CI, -0.55%-0.79%) FIM to LIADL r=0.532 (P=0.01, 95% CI, -0.36%-0.67%). Mann-Whitney U test was done to compare FIM, LIADL, and CIQ between stroke affection side (right vs left) and stroke sub-type (ischemic vs haemorrhagic), and no significant difference was found.
Conclusion: Functional independence, instrumental activities of daily living, and community reintegration are associated with each other. Hence, community reintegration should be incorporated into stroke rehabilitation to maintain a meaningful life as a part of society and family.

National Collaborating Centre for Chronic Conditions (Great Britain). Stroke: National clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). Royal College of Physicians. 2008. [PMID]

Hewer RL, Tennant A. The epidemiology of disabling neurological disorders. In: Greenwood RJ, McMillan TM, Barnes MP, Ward CD, editors. Handbook of neurological rehabilitation. Psychology Press; 2005. [Link]

Rangel ES, Belasco AG, Diccini S. Qualidade de vida de pacientes com acidente vascular cerebral em reabilitação. Acta Paul Enferm. 2013; 26(2):205-12. [DOI:10.1590/S0103-21002013000200016]

Wolf TJ, Baum C, Connor LT. Changing face of stroke: Implications for occupational therapy practice. The American Journal of Occupational Therapy: Official Publication of The American Occupational Therapy Association. 2009; 63(5):621-5. [DOI:10.5014/ajot.63.5.621] [PMID] [PMCID]

Elkins JS, Johnston SC. Thirty-year projections for deaths from ischemic stroke in the United States. Stroke. 2003; 34(9):2109-12. [DOI:10.1161/01.STR.0000085829.60324.DE] [PMID]

Banerjee TK, Das SK. Fifty years of stroke researches in India. Annals of Indian Academy of Neurology. 2016; 19(1):1-8.[DOI:10.4103/0972-2327.168631] [PMID] [PMCID]

Bonita R, Mendis S, Truelsen T, Bogousslavsky J, Toole J, Yatsu F. The global stroke initiative. The Lancet. Neurology. 2004; 3(7):391-3. [DOI:10.1016/S1474-4422(04)00800-2] [PMID]

Dalal PM, Malik S, Bhattacharjee M, Trivedi ND, Vairale J, Bhat P, et al. Population-based stroke survey in Mumbai, India: Incidence and 28-day case fatality. Neuroepidemiology. 2008; 31(4):254-61 [DOI:10.1159/000165364] [PMID]

Bendz M. Rules of relevance after a stroke. Social Science & Medicine. 2000; 51(5):713-23. [DOI:10.1016/S0277-9536(99)00486-4] [PMID]

Bendz M. The first year of rehabilitation after a stroke-from two perspectives. Scandinavian Journal of Caring Sciences. 2003; 17(3):215-22. [DOI:10.1046/j.1471-6712.2003.00217.x] [PMID]

Medin J, Barajas J, Ekberg K. Stroke patients’ experiences of return to work. Disability and Rehabilitation. 2006; 28(17):1051-60. [DOI:10.1080/09638280500494819] [PMID]

Low JT, Kersen P, Ashburn A, George S, McLellan DL. A study to evaluate the met and unmet needs of members belonging to Young Stroke groups affiliated with the Stroke Association. Disability and Rehabilitation. 2003; 25(18):1052-6. [DOI:10.1080/0963828031000069753] [PMID]

Baum CM, Law M. Occupational therapy practice: Focusing on occupational performance. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association. 1997; 51(4):277-88. [DOI:10.5014/ajot.51.4.277] [PMID]

Hebert D, Lindsay MP, McIntyre A, Kirton A, Rumney PG, Bagg S, et al. Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015. International Journal of Stroke: Official Journal of the International Stroke Society. 2016; 11(4):459-84. [DOI:10.1177/1747493016643553] [PMID]

Van Velzen JM, Van Bennekom CA, Edelaar MJ, Sluiter JK, Frings-Dresen MH. Prognostic factors of return to work after acquired brain injury: A systematic review. Brain Injury. 2009; 23(5):385-95. [DOI:10.1080/02699050902838165] [PMID]

Garrelfs SF, Donker-Cools BH, Wind H, Frings-Dresen MH. Return-to-work in patients with acquired brain injury and psychiatric disorders as a comorbidity: A systematic review. Brain Injury. 2015; 29(5):550-7. [DOI:10.3109/02699052.2014.995227] [PMID]

Ghanbari Ghoshchi S, De Angelis S, Morone G, Panigazzi M, Persechino B, Tramontano M, et al. Return to work and quality of life after stroke in italy: A study on the efficacy of technologically assisted neurorehabilitation. International Journal of Environmental Research and Public Health. 2020; 17(14):5233. [DOI:10.3390/ijerph17145233] [PMID] [PMCID]

Olaoye OA, Adejumobi AS, Olasusi AO, Aladesuyi OB, Emechete A. 2017. Relationship between community integration and life satisfaction among stroke survivors dwelling in rural communities of southwest, Nigeria. Journal of Environmental and Occupational Science. 2017; 6(1):19-26. [Link]

Saeki S, Toyonaga T. Determinants of early return to work after first stroke in Japan. Journal of Rehabilitation Medicine. 2010; 42(3):254-8. [DOI:10.2340/16501977-0503] [PMID]

Walsh ME, Galvin R, Loughnane C, Macey C, Horgan NF. Factors associated with community reintegration in the first year after stroke: A qualitative meta-synthesis. Disability and Rehabilitation. 2015; 37(18):1599-608. [DOI:10.3109/09638288.2014.974834] [PMID]

Tanaka H, Toyonaga T, Hashimoto H. Functional and occupational characteristics predictive of a return to work within 18 months after stroke in Japan: Implications for rehabilitation. International Archives of Occupational and Environmental Health. 2014; 87(4):445-53. [DOI:10.1007/s00420-013-0883-8] [PMID] [PMCID]

van der Kemp J, Kruithof WJ, Nijboer TC, van Bennekom CA, van Heugten C, Visser-Meily JM. Return to work after mild-to-moderate stroke: work satisfaction and predictive factors. Neuropsychological Rehabilitation. 2019; 29(4):638-53. [DOI:10.1080/09602011.2017.1313746] [PMID]

Obembe A, Mapayi B, Johnson O, Agunbiade T, Emechete A. Community reintegration in stroke survivors: Relationship with motor function and depression. Hong Kong Physiotherapy Journal. 2013; 31(2):69-74. [DOI:10.1016/j.hkpj.2013.04.001]

Hamzat TK, Olaleye OA, Akinwumi OB. Functional ability, community reintegration and participation restriction among community-dwelling female stroke survivors in Ibadan. Ethiopian Journal of Health Sciences. 2014; 24(1):43-8. [DOI:10.4314/ejhs.v24i1.6] [PMID] [PMCID]

Wyller TB, Ranhoff AH, Bautz-Holter E. Validity of questionnaire information from old people on previous cerebral stroke. J Stroke Cerebrovascular Diseases. 1994; 4(1):57-8. [DOI:10.1159/000108452]

Hirsh AT, Braden AL, Craggs JG, Jensen MP. Psychometric properties of the community integration questionnaire in a heterogeneous sample of adults with physical disability. Archives of Physical Medicine and Rehabilitation. 2011; 92(10):1602-10. [DOI:10.1016/j.apmr.2011.05.004] [PMID] [PMCID]

Graf C. Functional decline in hospitalized older adults. The American Journal of Nursing. 2006; 106(1):58-67. [DOI:10.1097/00000446-200601000-00032] [PMID]

Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3):179-86. [PMID]

LaPlante MP. The classic measure of disability in activities of daily living is biased by age but an expanded IADL/ADL measure is not. The Journals of Gerontology. Series B, Psychological sciences and Social Sciences. 2010; 65(6):720-32 [DOI:10.1093/geronb/gbp129] [PMID] [PMCID]

Ahmad MA, Singh DKA, Mohd Nordin NA, Hooi Nee K, Ibrahim N. Virtual reality games as an adjunct in improving upper limb function and general health among stroke survivors. International Journal of Environmental Research and Public Health. 2019; 16(24):5144. [DOI:10.3390/ijerph16245144] [PMID] [PMCID]

Kidd D, Stewart G, Baldry J, Johnson J, Rossiter D, Petruckevitch A, et al. The functional independence measure: A comparative validity and reliability study. Disability and Rehabilitation. 1995; 17(1):10-4. [DOI:10.3109/09638289509166622] [PMID]

Hsueh IP, Lin JH, Jeng JS, Hsieh CL. Comparison of the psychometric characteristics of the functional independence measure, 5 item Barthel index, and 10 item Barthel index in patients with stroke. Journal of Neurology, Neurosurgery, and Psychiatry. 2002; 73(2):188- 90. [DOI:10.1136/jnnp.73.2.188] [PMID] [PMCID]

Chau JP, Thompson DR, Twinn S, Chang AM, Woo J. Determinants of participation restriction among community dwelling stroke survivors: A path analysis. BMC Neurology. 2009; 9:49. [DOI:10.1186/1471-2377-9-49] [PMID] [PMCID]

Stumbo NJ, Wilder A, Zahl M, DeVries D, Pegg S, Greenwood J, et al. Community integration: Showcasing the evidence for therapeutic recreation services. Therapeutic Recreation Journal. 2015; 49(1):35. [Link]

Paolucci S. Epidemiology and treatment of post-stroke depression. Neuropsychiatric Disease and Treatment. 2008; 4(1):145-54. [DOI:10.2147/NDT.S2017] [PMID] [PMCID]

Shah S, Vanclay F, Cooper B. Predicting discharge status at commencement of stroke rehabilitation. Stroke. 1989; 20(6):766-9. [DOI:10.1161/01.STR.20.6.766] [PMID]

Zorowitz RD, Robinson KM. Pathophysiology of dysphagia and aspiration. Topics in Stroke Rehabilitation. 1999; 6(3):1-6. [DOI:10.1310/LT3H-H5UF-F6V9-6KK8]

Kwakkel G, Wagenaar RC. Effect of duration of upper-and lower-extremity rehabilitation sessions and walking speed on recovery of interlimb coordination in hemiplegic gait. Physical Therapy. 2002; 82(5):432-48. [DOI:10.1093/ptj/82.5.432] [PMID]

Laufer Y, Sivan D, Schwarzmann R, Sprecher E. Standing balance and functional recovery of patients with right and left hemiparesis in the early stages of rehabilitation. Neurorehabilitation and Neural Repair. 2003; 17(4):207-13. [DOI:10.1177/0888439003259169] [PMID]

Teasell RW, Jutai JW, Bhogal SK, Foley NC. Research gaps in stroke rehabilitation. Topics in Stroke Rehabilitation. 2003; 10(1):59-70. [DOI:10.1310/G8PK-R5EF-BMAY-KT5T]

Ghasemi A, Taghizade G, Gharegozli K. Comparing the effect of speedy and endurance walking on postural control and the time for returning to baseline after walking in patients with chronic stroke and healthy subjects. Journal of Modern Rehabilitation. 2016; 10(1):1-6. [Link]

Files
IssueVol 17 No 3 (2023) QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/jmr.v17i3.13069
Keywords
Stroke Community reintegration Functional performance Rehabilitation

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mohakud K, Prasad Das S, Sahoo S, Sahu S. Functional Performance and Community Reintegration of Chronic Post-Stroke Survivors in Eastern India. jmr. 2023;17(3):290-297.