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PREDICTIVE FACTORS AT HOSPITAL DISCHARGE FOR DEVELOPMENT OF LEARNED NON-USE IN STROKE

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ESOC-2019

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Abstract

Background: Approximately 55 to 85% of post-stroke individuals present upper-limb compromise. Aim: To evaluate the predictive factors in the acute phase of the patient after stroke for development of learned non-use of the affected upper limb. Method: This is a prospective cohort study with 38 patients with ischemic stroke diagnosis. At hospital discharge data were collected on clinical and sociodemographic aspects, risk factors, scales of severity and incapacity (NIHSS, mRs and Barthel), as well as neuromuscular (muscle tone and handgrip strength) and sensory evaluation. At 90 days after hospital discharge the Motor Activity Log Scale for detecting learned non-use was obtained, and quality of life by Euroqol. The individuals with and without learned non-use were compared by the t test, and generalized linear model was employed to find possible predictors. Significance level 5%. Results: Comparing the 2 groups, significance was found to age (p=0.008), creatine (p=0.006), handgrip strength (p<0.001), tactile hypoesthesia (p<0.001), NIHSS at discharge (p<0.001), incapacity by mRs (p=0.015) and Barthel (p=0.021) at discharge and general perception of quality of life (p=0.002). These variables had lower mean values in the learned non-use group. In the generalized linear model, age (β=0.003, p=0.006), NIHSS at discharge (β=-0.230, p=0.036), handgrip strength (β=0.057, p=0.000), altered sensitivity (β=0.659, p=0.011), mRs at discharge (β=0.498, p=0.009) and Barthel at discharge (β=0.057, p=0.011) were found to be associated with learned non-use evaluated by Motor Activity Log Scale. Conclusion: Age, severity, incapacity, neuromuscular and sensory compromise are predictors do learned non-use in stroke chronic phase.

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© Copyright 2020 Morressier GmbH.
All rights reserved.