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Grau-Pellicer M1, Chamarro-Lusar A2, Medina-Casanovas J3, Serdà i Ferrer B-C4
1Autonomous University of Barcelona, Physical Therapy Department, Barcelona, Spain, 2Autonomous University of Barcelona, Basic, Evolutionary, and Educational Psychology Department, Barcelona, Spain, 3Institut Guttmann, Functional Rehabilitation Department, Badalona, Spain, 4Universitat de Girona, Department of Nursing, and Biomedical Research Institute, Girona, Spain
Background: The increase in the incidence of stroke has augmented the number of chronically ill patients with disabilities. This causes a great impact on Health Related Quality of Life (HRQoL) of the affected people. Improving HRQoL is a goal of stroke rehabilitation. The use of HRQoL scales is fundamental in the evaluation of the effectiveness of therapeutic interventions taking into account the perception of the user. The Euroquol instrument (EQ-5D-5L) is a generic HRQoL questionnaire, validated for people who have suffered a strokeIt consists of two parts:
1) descriptive system that defines health in terms of 5 dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression;
2) respondents also rate their overall health on a visual analogue scale.
This is as simple and comfortable instrument for assessing HRQoL. The stroke-adapted 30-item version of the Sickness Impact Profile (SIP30-SA) is composed of thirty items classified in two dimensions with four categories each:
1) physical (care and body movement, mobility, homework and displacement) and
2) psychosocial (social relationships, communication, emotional activity and intellectual activity).
This is a very useful instrument for defining with accuracy rehabilitation objectives and the evolution of people affected by stroke. It is important to decide which the most useful HRQoL instrument is in physiotherapists' daily clinical practice.
Purpose: To compare the questionnaires EQ-5D-5L and SIP30-AI in the study of the impact on HRQoL of a post-stroke rehabilitation program based on aerobic exercise to improve walking speed.
Methods: An observational repeated-measures design was used. Thirty one participants underwent a 12-week rehabilitation program. Participants were evaluated at baseline, post-intervention and at six months. It was assessed walking speed with the Ten Meter Walking Test (10MWT) and HRQoL with the two instruments: EQ-5D-5L and SIP30-AI. Data analysis: The nonparametric Friedman's test was used to compare means of the three repeated measurements. The effect size was estimated using Cohen's d. Subsequently was analyzed Pearson coefficient to compare the correlation of the two HRQoL instruments.
Results: Twenty-five participants completed the rehabilitation program. At the end of the intervention and six month later, comfortable walking speed increased 0.16m/sec. and 0.23m/sec, respectively. HRQoL improved statistically in both instruments. A statistically significant correlation of the ambulation velocity with the HRQoL was observed. It was also observed a statistically significant correlation between the EQ-5D-5L and the SIP30-AI.
Conclusion(s): The improvement observed after the application of a rehabilitation program based on aerobic exercise, demonstrates that participants obtain an increase of walking speed that correlates with the improvement of HRQoL. Furthermore, it was observed a significant correlation between both HRQoL questionnaires (EQ-5D-5L and SIP30-AI).
Implications: It is important to evaluate HRQoL after stroke rehabilitation program. In daily clinical practice, physiotherapists could use any of the two instruments since they correlate between them. The EQ-5D-5L is a generic scale, simple to use for participants, that allows comparisons between the healthy population and the one affected by stroke. The SIP-30 SA is a specific scale for stroke survivors that explores more deeply into the consequences of stroke, but it is more complex for the participant when using it.
Keywords: Stroke, Quality of Life, Rehabilitation
Funding acknowledgements: The authors declare no conflict of interest
1) descriptive system that defines health in terms of 5 dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression;
2) respondents also rate their overall health on a visual analogue scale.
This is as simple and comfortable instrument for assessing HRQoL. The stroke-adapted 30-item version of the Sickness Impact Profile (SIP30-SA) is composed of thirty items classified in two dimensions with four categories each:
1) physical (care and body movement, mobility, homework and displacement) and
2) psychosocial (social relationships, communication, emotional activity and intellectual activity).
This is a very useful instrument for defining with accuracy rehabilitation objectives and the evolution of people affected by stroke. It is important to decide which the most useful HRQoL instrument is in physiotherapists' daily clinical practice.
Purpose: To compare the questionnaires EQ-5D-5L and SIP30-AI in the study of the impact on HRQoL of a post-stroke rehabilitation program based on aerobic exercise to improve walking speed.
Methods: An observational repeated-measures design was used. Thirty one participants underwent a 12-week rehabilitation program. Participants were evaluated at baseline, post-intervention and at six months. It was assessed walking speed with the Ten Meter Walking Test (10MWT) and HRQoL with the two instruments: EQ-5D-5L and SIP30-AI. Data analysis: The nonparametric Friedman's test was used to compare means of the three repeated measurements. The effect size was estimated using Cohen's d. Subsequently was analyzed Pearson coefficient to compare the correlation of the two HRQoL instruments.
Results: Twenty-five participants completed the rehabilitation program. At the end of the intervention and six month later, comfortable walking speed increased 0.16m/sec. and 0.23m/sec, respectively. HRQoL improved statistically in both instruments. A statistically significant correlation of the ambulation velocity with the HRQoL was observed. It was also observed a statistically significant correlation between the EQ-5D-5L and the SIP30-AI.
Conclusion(s): The improvement observed after the application of a rehabilitation program based on aerobic exercise, demonstrates that participants obtain an increase of walking speed that correlates with the improvement of HRQoL. Furthermore, it was observed a significant correlation between both HRQoL questionnaires (EQ-5D-5L and SIP30-AI).
Implications: It is important to evaluate HRQoL after stroke rehabilitation program. In daily clinical practice, physiotherapists could use any of the two instruments since they correlate between them. The EQ-5D-5L is a generic scale, simple to use for participants, that allows comparisons between the healthy population and the one affected by stroke. The SIP-30 SA is a specific scale for stroke survivors that explores more deeply into the consequences of stroke, but it is more complex for the participant when using it.
Keywords: Stroke, Quality of Life, Rehabilitation
Funding acknowledgements: The authors declare no conflict of interest
Topic: Neurology: stroke
Ethics approval required: Yes
Institution: Hospital-Consorci Sanitari de Terrassa, Barcelona (Spain)
Ethics committee: Medical Ethical Committee of the Hospital-Consorci Sanitari de Terrassa
Ethics number: 02-13-119-020.
All authors, affiliations and abstracts have been published as submitted.
