Functional outcomes among stroke patients in Alagoas, Brazil: observational study

ABSTRACT BACKGROUND: Stroke is the principal cause of disability around the world and the ensuing functional dependence (FD) can be correlated with different factors. OBJECTIVE: To determine how demographic factors and clinical characteristics after stroke distinguish patients who achieve functional independence from those who do not. DESIGN AND SETTING: Observational study at specialized neurovascular clinic in Alagoas, Brazil. METHODS: FD was classified according to the modified Rankin scale (mRs): 0 to 2 points were classified as independent (FD-), and 3 to 5 points were classified as dependent (FD+). Logistic regression analysis included age, sedentary lifestyle, the Center for Epidemiological Studies - Depression Scale (CES-D) and the National Institutes of Health Stroke Scale (NIHSS). The Mann-Whitney test and χ2 test were used to compare groups. RESULTS: We included 190 stroke patients with a mean age of 60.02 ± 14.22 years. We found that 34.8% of the patients were classified as FD+. Lower NIHSS and CES-D scores were more associated with achieving functional independence. Most of the patients had access to physical therapy, and the mean duration of rehabilitation therapy was 65.2 minutes per week. Females had higher prevalence of depressive symptoms (P = 0.005) and rehabilitation time was shorter for hemorrhagic stroke (P = 0.02). CONCLUSION: We found a FD rate four times greater than in another Brazilian study. Lower stroke severity and fewer depressive symptoms were associated with achieving functional independence. Less than half of the patients were referred to a rehabilitation service at hospital discharge and few had access to multidisciplinary treatment.

Correlação entre a funcionalidade e a força muscular periférica em pacientes renais crônicos submetidos à hemodiálise / Correlation between functionality and a peripheral muscle strength in chronic renal patients undergoing hemodialysis

Introdução: A hemodiálise é um tratamento que acarreta diversas complicações nos sistemas muscular, metabólico e cardiorrespiratório, comprometendo a funcionalidade e força muscular periférica do paciente. Objetivo: Correlacionar à funcionalidade e a força muscular periférica em pacientes renais crônicos submetidos à hemodiálise. Métodos: Tratou-se de um estudo transversal com pacientes renais crônicos. Para avaliação de força muscular foi o utilizado o Medical Research Council (MRC). Durante a sessão de hemodiálise foi aplicado o questionário de Medida de Independência Funcional (MIF), que avalia a funcionalidade do indivíduo. Resultados: No estudo não foi encontrada correlação significativa entre MRC Total e MIF Total. Entretanto, foi observada uma correlação significativa e negativa entre idade e MRC total Conclusão: Foi possível analisar o perfil dos pacientes acometidos pela Doença Renal Crônica (DRC). Constatou-se que pacientes renais que apresentavam idade mais avançada possuíam um grau de força muscular reduzida.

Hemodialysis is a treatment that entails several complications in the muscular, metabolic and cardiorespiratory systems, compromising the functionality and the peripheral muscular strength of the patient. Objective: To correlate peripheral muscle function and strength in chronic renal patients undergoing hemodialysis. Methods: This was a cross-sectional study with chronic renal patients. For evaluation of muscle strength was used the Medical Research Council (MRC). During the hemodialysis session, the Functional Independence Measure (MIF) questionnaire was applied, which evaluates the individual's functionality. Results: No significant correlation between MRC Total and MIF Total was found in the study. However, a significant and negative correlation was observed between age and total RRM. Conclusion: It was possible to analyze the profile of patients affected by chronic kidney disease (CKD). It was found that renal patients who were more advanced age had a reduced degree of muscular strength.