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Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research

The negative impact of spasticity on the health-related quality of life of stroke survivors: a longitudinal cohort study

Authors: Patrick J. Gillard, Heidi Sucharew, Dawn Kleindorfer, Samir Belagaje, Sepideh Varon, Kathleen Alwell, Charles J. Moomaw, Daniel Woo, Pooja Khatri, Matthew L. Flaherty, Opeolu Adeoye, Simona Ferioli, Brett Kissela

Published in: Health and Quality of Life Outcomes | Issue 1/2015

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Abstract

Background

Spasticity often leads to symptomatic and functional problems that can cause disability for stroke survivors. We studied whether spasticity has a negative impact on health-related quality of life (HRQoL).

Methods

As part of the Greater Cincinnati/Northern Kentucky Stroke Study (NCT00642213), 460 ischemic stroke patients were interviewed during hospitalization and then followed over time. HRQoL was measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Short Form-12 (SF-12), EuroQol-5 dimension (EQ-5D), and Stroke-Specific Quality of Life (SSQOL) instruments, with lower scores indicating worse health. HRQoL differences between stroke survivors with and without spasticity were compared, adjusting for age, race, stroke severity, pre-stroke function, and comorbidities.

Results

Of the 460 ischemic stroke patients, 328 had spasticity data available 3 months after their stroke (mean age of 66 years, 49 % were female, and 26 % were black). Of these patients, 54 (16 %) reported having spasticity. Three months following their stroke, patients who reported spasticity had lower mean scores on the PCS (29.6 ± 1.4 vs 37.3 ± 0.6; P < .001), EQ-5D (0.59 ± 0.03 vs 0.71 ± 0.01; P < .001), and SSQOL (3.57 ± 0.08 versus 3.78 ± 0.03; P = .03) compared with patients who did not report spasticity. Lower HRQoL scores were also observed at the 1-year (PCS, EQ-5D, and SSQOL) and 2-year (EQ-5D and SSQOL) interviews in those with spasticity compared with those without spasticity.

Conclusions

Statistically and clinically meaningful differences in HRQoL exist between stroke survivors with and without spasticity.
Literature
1.
go back to reference Mackay J, Mensah G. The atlas of heart disease and stroke. Geneva: World Health Organization; 2004. Mackay J, Mensah G. The atlas of heart disease and stroke. Geneva: World Health Organization; 2004.
2.
go back to reference Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–e245.CrossRefPubMed Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–e245.CrossRefPubMed
3.
go back to reference Opheim A, Danielsson A, Alt Murphy M, Persson HC, Sunnerhagen KS. Upper-limb spasticity during the first year after stroke: stroke arm longitudinal study at the University of Gothenburg. Am J Phys Med Rehabil. 2014;93:884–96.CrossRefPubMed Opheim A, Danielsson A, Alt Murphy M, Persson HC, Sunnerhagen KS. Upper-limb spasticity during the first year after stroke: stroke arm longitudinal study at the University of Gothenburg. Am J Phys Med Rehabil. 2014;93:884–96.CrossRefPubMed
4.
go back to reference Urban PP, Wolf T, Uebele M, Marx JJ, Vogt T, Stoeter P, et al. Occurence and clinical predictors of spasticity after ischemic stroke. Stroke. 2010;41:2016–20.CrossRefPubMed Urban PP, Wolf T, Uebele M, Marx JJ, Vogt T, Stoeter P, et al. Occurence and clinical predictors of spasticity after ischemic stroke. Stroke. 2010;41:2016–20.CrossRefPubMed
5.
go back to reference Sommerfeld DK, Gripenstedt U, Welmer AK. Spasticity after stroke: an overview of prevalence, test instruments, and treatments. Am J Phys Med Rehabil. 2012;91:814–20.CrossRefPubMed Sommerfeld DK, Gripenstedt U, Welmer AK. Spasticity after stroke: an overview of prevalence, test instruments, and treatments. Am J Phys Med Rehabil. 2012;91:814–20.CrossRefPubMed
6.
7.
go back to reference Esquenazi A. The human and economic burden of poststroke spasticity and muscle overactivity. J Clin Outcomes Manag. 2011;18:607–14. Esquenazi A. The human and economic burden of poststroke spasticity and muscle overactivity. J Clin Outcomes Manag. 2011;18:607–14.
8.
go back to reference Broderick J, Brott T, Kothari R, Miller R, Khoury J, Pancioli A, et al. The Greater Cincinnati/Northern Kentucky Stroke Study: preliminary first-ever and total incidence rates of stroke among blacks. Stroke. 1998;29:415–21.CrossRefPubMed Broderick J, Brott T, Kothari R, Miller R, Khoury J, Pancioli A, et al. The Greater Cincinnati/Northern Kentucky Stroke Study: preliminary first-ever and total incidence rates of stroke among blacks. Stroke. 1998;29:415–21.CrossRefPubMed
9.
go back to reference Williams LS, Yilmaz EY, Lopez-Yunez AM. Retrospective assessment of initial stroke severity with the NIH Stroke Scale. Stroke. 2000;31:858–62.CrossRefPubMed Williams LS, Yilmaz EY, Lopez-Yunez AM. Retrospective assessment of initial stroke severity with the NIH Stroke Scale. Stroke. 2000;31:858–62.CrossRefPubMed
10.
go back to reference Kissela B, Lindsell CJ, Kleindorfer D, Alwell K, Moomaw CJ, Woo D, et al. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. Stroke. 2009;40:530–6.PubMedCentralCrossRefPubMed Kissela B, Lindsell CJ, Kleindorfer D, Alwell K, Moomaw CJ, Woo D, et al. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. Stroke. 2009;40:530–6.PubMedCentralCrossRefPubMed
12.
go back to reference Shaw JW, Johnson JA, Coons SJ. US valuation of the EQ-5D health states: development and testing of the D1 valuation model. Med Care. 2005;43:203–20.CrossRefPubMed Shaw JW, Johnson JA, Coons SJ. US valuation of the EQ-5D health states: development and testing of the D1 valuation model. Med Care. 2005;43:203–20.CrossRefPubMed
13.
go back to reference Dorman PJ, Waddell F, Slattery J, Dennis M, Sandercock P. Is the EuroQol a valid measure of health-related quality of life after stroke? Stroke. 1997;28:1876–82.CrossRefPubMed Dorman PJ, Waddell F, Slattery J, Dennis M, Sandercock P. Is the EuroQol a valid measure of health-related quality of life after stroke? Stroke. 1997;28:1876–82.CrossRefPubMed
14.
go back to reference Office of Public Health Assessment, Center for Health Data. Health Status in Utah: The Medical Outcomes Study SF-12 (2001 Utah Health Status Survey Report). Salt Lake City: Utah Department of Health; 2004. Office of Public Health Assessment, Center for Health Data. Health Status in Utah: The Medical Outcomes Study SF-12 (2001 Utah Health Status Survey Report). Salt Lake City: Utah Department of Health; 2004.
15.
go back to reference Williams LS, Redmon G, Saul DC, Weinberger M. Reliability and telephone validity of the Stroke-Specific Quality of Life (SS-QOL) scale. Stroke. 2000;32:339-b. Williams LS, Redmon G, Saul DC, Weinberger M. Reliability and telephone validity of the Stroke-Specific Quality of Life (SS-QOL) scale. Stroke. 2000;32:339-b.
16.
go back to reference Williams LS, Stump T, McHorney CA. Development of the Stroke-Specific Quality of Life (SS-QOL) scale: item and domain reduction. Stroke. 2003;34:236.CrossRef Williams LS, Stump T, McHorney CA. Development of the Stroke-Specific Quality of Life (SS-QOL) scale: item and domain reduction. Stroke. 2003;34:236.CrossRef
17.
go back to reference Post MW, Boosman H, van Zandvoort MM, Passier PE, Rinkel GJ, Visser-Meily JM. Development and validation of a short version of the Stroke Specific Quality of Life Scale. J Neurol Neurosurg Psychiatry. 2011;82:283–6.CrossRefPubMed Post MW, Boosman H, van Zandvoort MM, Passier PE, Rinkel GJ, Visser-Meily JM. Development and validation of a short version of the Stroke Specific Quality of Life Scale. J Neurol Neurosurg Psychiatry. 2011;82:283–6.CrossRefPubMed
18.
go back to reference Hofer SM, Hoffman L. Statistical analysis with incomplete data: a developmental perspective. In: Little TD, Bovaird JA, Card NA, editors. Modeling contextual effects in longitudinal studies. Mahwah: LEA; 2007. p. 13–32. Hofer SM, Hoffman L. Statistical analysis with incomplete data: a developmental perspective. In: Little TD, Bovaird JA, Card NA, editors. Modeling contextual effects in longitudinal studies. Mahwah: LEA; 2007. p. 13–32.
19.
go back to reference Abubakar SA, Isezuo SA. Health related quality of life of stroke survivors: experience of a stroke unit. Int J Biomed Sci. 2012;8:183–7.PubMedCentralPubMed Abubakar SA, Isezuo SA. Health related quality of life of stroke survivors: experience of a stroke unit. Int J Biomed Sci. 2012;8:183–7.PubMedCentralPubMed
20.
go back to reference Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005;14:1523–32.CrossRefPubMed Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005;14:1523–32.CrossRefPubMed
21.
go back to reference Le QA, Doctor JN, Zoellner LA, Feeny NC. Minimal clinically important differences for the EQ-5D and QWB-SA in Post-traumatic Stress Disorder (PTSD): results from a Doubly Randomized Preference Trial (DRPT). Health Qual Life Outcomes. 2013;11:59.PubMedCentralCrossRefPubMed Le QA, Doctor JN, Zoellner LA, Feeny NC. Minimal clinically important differences for the EQ-5D and QWB-SA in Post-traumatic Stress Disorder (PTSD): results from a Doubly Randomized Preference Trial (DRPT). Health Qual Life Outcomes. 2013;11:59.PubMedCentralCrossRefPubMed
Metadata
Title
The negative impact of spasticity on the health-related quality of life of stroke survivors: a longitudinal cohort study
Authors
Patrick J. Gillard
Heidi Sucharew
Dawn Kleindorfer
Samir Belagaje
Sepideh Varon
Kathleen Alwell
Charles J. Moomaw
Daniel Woo
Pooja Khatri
Matthew L. Flaherty
Opeolu Adeoye
Simona Ferioli
Brett Kissela
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0340-3

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