Measuring quality of life in stroke.

Abstract

Background and Purpose: Little attention has been focused on quality of life in stroke outcome research. The purpose of this review is to outline the meaning of the concept, describe important methodological issues and methods of assessment, review existing quality of life measures, and discuss criteria for selecting an appropriate instrument.Summary ofReview:The following 10 quality of life instruments were reviewed: COOP Charts; Euroqol; Frenchay Activities Index; Karnofsky Performance Status Scale; McMaster Health Index Questionnaire; Medical Outcomes Study 20-Item Short-Form Health Survey; Nottingham Health Profile; Quality of Life Index; Quality of Well-being Scale; and the Sickness Impact Profile. They were evaluated in terms of length, time needed to complete, content, scoring, and psychometric characteristics.Conclusions: Emphasis should be placed on further psychometric evaluation of existing quality of life measures rather than on generating new instruments. There is particular need for supplementary data on the responsiveness of the instruments to changes in patients' clinical status over time. The choice of a suitable quality of life instrument should be based not only on psychometric properties but also on careful consideration of the research question, the relevance to the objectives of the study, the feasibility of the instrument, and the specific characteristics of the stroke patients under investigation. (Stroke 1993;24:320-327) KEY WORDs * quality of life * stroke outcome

Clinical and Finite Element Analysis of Acute Whiplash

“…While the ASIA scale does not measure spasticity, coordination or gait-it is useful as a metric to register subtle changes in sensory and motor function. The Karnofsky Index was designed as a functional index for cancer patients, but has also been used in other areas as a reliable means of assessing function [9]. The Brainstem Disability Index [5] used in this report is not validated, but is used by the authors to measure improvement in the panoply of symptoms generally attributed to neurological dysfunction of the brainstem based upon the encyclopedic descriptions of others [10][11][12][13][14][15][16][17][18][19][20][21].…”

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“…This review is guided by Wilson and Cleary HRQOL model [25] and the HRQOL dimensions reported in de Haan, et al [24].…”

“…The psychological health includes emotional status and cognitive functioning [24]. Presence of emotional symptoms such as anxiety [30] or Depression adversely affects HRQOL [30,31,32,33,34,35] more than the impairment of physical function [33] because depression negatively influence physical function [34].…”

“…Functional health domain includes mobility selfcare and level of physical activity [24]. Studies have shown that impairment of physical function post stroke adversely affects HRQOL [30,31,35,40].…”

“…This involves the assessment of the levels of social contacts and interactions [24]. The psychological and physical consequences of stroke may lead to a decrease in the survivors' level of social function [33,42].…”