Relationship Between Disability and Health‐Related Quality of Life and Caregiver Burden in Patients With Upper Limb Poststroke Spasticity

Doan, Quan V.; Brashear, Allison; Gillard, Patrick; Varon, Sepideh F.; VanDenburgh, Amanda M.; Turkel, Catherine C.; Elovic, Elie P.

doi:10.1016/j.pmrj.2011.10.001

Cited by 105 publications

(106 citation statements)

References 21 publications

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“…These activity limitations increase caregiver burden and reduce quality of life as measured by the EuroQol-5. 539 When spasticity is present, the cost of care is 4 times higher than when spasticity is absent; however, because spasticity is strongly associated with stroke severity, the independent impact of spasticity on costs is not known. 540 Thus, the cost of treating spasticity may not reduce the overall cost of stroke-related care.…”

Section: Spasticitymentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,068

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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Section: Spasticitymentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,068

840

View full text Add to dashboard Cite

show abstract

“…Spasticity can also affect quality-of-life and be highly detrimental to daily function [15]. There is currently a lack of specific guidelines for the stratification and individualization of rehabilitation programmes.…”

Section: Introductionmentioning

confidence: 99%

Spasticity after stroke: Physiology, assessment and treatment

et al. 2013

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Background: Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood. Method: This review aims to define spasticity, describe hypotheses explaining its development after a stroke, give an overview of related neuroimaging studies as well as a description of the most common scales used to quantify the degree of spasticity and finally explore which treatments are currently being used to treat this disorder. Results: The lack of consensus is highlighted on the basis of spasticity and the associated absence of guidelines for treatment, use of drugs and rehabilitation programmes. Conclusions: Future studies require controlled protocols to determine the efficiency of pharmacological and non-pharmacological treatments for spasticity. Neuroimaging may help predict the occurrence of spasticity and could provide insight into its neurological basis.

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“…However, it is very important to manage spasticity because it is a significant contributor to functional impairment, reduced activities of daily living (ADL) and poorer quality of life (QoL). [2,3] As such, the management of spasticity plays an important role on the journey to autonomy, independence and increased self-esteem. However, the ''life impact'' of spasticity is often taken for granted by professionals and there is actually very little information about what matters most to the patient and their families.…”

Section: Introductionmentioning

confidence: 99%

An international survey of patients living with spasticity

Barnes

Koçer

Fernandez³

et al. 2016

Disability and Rehabilitation

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Purpose: To better understand patient perspectives on the life impact of spasticity. Methods: Global Internet survey (April 2014-May 2015 of 281 people living with spasticity. Results: Respondents indicated that spasticity has a broad impact on their daily-life: 72% reported impact on quality of life, 44% reported loss of independence and 44% reported depression. Most respondents (64%) were cared for by family members, of whom half had stopped working or reduced their hours. Overall, 45% reported dissatisfaction with the information provided at diagnosis; main reasons were ''not enough information'' (67%) and ''technical terminology'' (36%). Respondents had high treatment expectations; 63% expected to be free of muscle spasm, 41% to take care of themselves and 36% to return to a normal routine. However, 33% of respondents had not discussed these expectations with their physician. The most common treatments were physiotherapy (75%), botulinum neurotoxin (BoNT, 73%) and oral spasmolytics (57%). Of those treated with BoNT, 47% waited >1 year from spasticity onset to treatment. Conclusions: This survey emphasises the broad impact of spasticity and highlights unmet needs in the patient journey. Improvements with regards to communication and the therapeutic relationship would be especially welcomed by patients, and would help manage treatment expectations. ä IMPLICATIONS OF REHABILITATIONSpasticity has broad impact on the lives of patients and their families that extends beyond the direct physical disability. Patients with spasticity need to be well informed about their condition and treatments available and should be given the opportunity to discuss their expectations. Physicians need to be aware of the patient's individual needs and expectations in order to better help them achieve their therapeutic goals. ARTICLE HISTORY

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Relationship Between Disability and Health‐Related Quality of Life and Caregiver Burden in Patients With Upper Limb Poststroke Spasticity

Cited by 105 publications

References 21 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Spasticity after stroke: Physiology, assessment and treatment

An international survey of patients living with spasticity

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