Regularity of Daily Activities in Stroke

Abstract

Various studies have been performed using the Social Rhythm Metric (SRM), though none has been developed with stroke patients. Stroke is a pathology that provokes a strong physical and social impact caused by an abnormality in cerebral circulation. Consequently, we performed two studies to validate the SRM and translate it into Portuguese, and to evaluate the regularity of the daily activities of stroke patients. Both healthy individuals and patients with unilateral cerebral lesions were evaluated. Subjects were of both sexes and between 45 and 65 yrs of age. Participants underwent clinical evaluation and recorded the time of 17 daily activities on the SRM for two weeks. Data were analyzed by the Pearson correlation and Fisher tests. After conceptual translation into Portuguese, corrections were made to arrive at the final version. Normative SRM scores varied from 3.2 to 7.0, suggesting that the activities presented in SRM adequately represented the daily routines of the patients. A correlation was found in SRM between the weeks (r=0.84; p=0.0001), indicating instrument reliability. The mean (+/-SD) score of the stoke patients was 4.8 (+/-1.0), and the correlation between the SRM and level of neurological damage showed that patients with lower SRM values were more physically compromised (r=-0.29; p=0.04), suggesting that SRM may be a clinical predictor. Activities related to eating and the sleep-wake cycle were rated by most patients. In all, 71% of the patients did not work, while 84% of healthy individuals did (p=0.001). Only 64% of patients left home compared to 90% of the healthy subjects (p=0.001), and 59% of patients recorded the activity of going home compared to 82% of healthy individuals (p=0.001). According to the results, there is evidence of the validity and reliability of the SRM, enabling it to be reliably used in chronobiological studies of stroke patients. Given that a less regular lifestyle may be associated with neurological compromise and a decrease in social activities, we suggest new studies with the repeated application of this instrument over the clinical evolution of the disease to better define improvement or worsening of the patient's condition in terms of their social and health aspects.

Elderly persons' experience and management of eating situations 6 months after stroke

“…One of most frequent functional activities in humans' everyday life is eating. Among healthy individuals in comparison to persons with stroke, no difference in eating activities was shown (Campos et al 2008). Eating is so much more than just a practical event, since eating was experienced as fundamental and common for all humans, this activity has become natural to share with others and even with unfamiliar people (Simmel 1994).…”

Psychometric properties of Social Rhythm Metric in regular shift employees

“…16 In 1990, investigators from the University of Pittsburgh developed an instrument to quantify social rhythms, the Social Rhythm Metric, or SRM-17, 16 which has been used in several studies to investigate the impact of lifestyle regularity on young adults, 17 parents of newborns, 18 elderly people, 19,20 patients with mood disorder, 16,21 anxiety 22 and stroke patients. 23 As a clinical instrument, the Social Rhythm Metric has been used in the United States in the therapeutic method referred to as Interpersonal and Social Rhythm Therapy for tracing alterations in daily life regularity of people with bipolar disorder, as there are evidences that reinforced social zeitgebers are the cause of clinical condition improvement in these patients, as observed in the reduced number of recurrences and increased interval between recurrences in patients submitted to this form of treatment. 24,25 The SRM-17 4,16,17 is a self-applicable scale where the respondent reports, during a certain period, which activities he/she has performed from a group of 15 fixed and two optional activities.…”

Actigraphic Analysis of the Sleep–Wake Cycle and Physical Activity Level in Patients with Stroke: Implications for Clinical Practice

“…In an earlier study, a correlation was observed between the social rhythm of patients, as measured by Social Rhythm Metric (SRM), and degree of neurological compromise. This indicates that more irregular patients were more compromised physically, suggesting SRM may be a clinical predictor (Campos et al, 2008). Boden-Albala et al (2005) confirmed that stroke-related functional impairment generally leads to social isolation and deprivation of social activities.…”