De Wit Liesbet, Molas Marek, Dejaeger Eddy, De Weerdt Willy, Feys Hilde, Jenni Walter, Lincoln Nadina, Putman Koen, Schupp Wilfried, Lesaffre Emmanuel
Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences Katholieke Universiteit Leuven, Belgium.
Neurorehabil Neural Repair. 2009 Oct;23(8):825-30. doi: 10.1177/1545968309337137. Epub 2009 Jun 4.
This study aimed to unravel the multidimensional profile of stroke outcomes by investigating the global correlation structure of motor, functional, and emotional problems of patients, as well as their caregivers' strain, at 6 months after stroke. Potential differential associations based on patients' level of functioning on admission to the rehabilitation center were analyzed.
Data were collected within the CERISE-study (Collaborative Evaluation of Rehabilitation in Stroke across Europe). Six months after stroke, the Rivermead Motor Assessment (RMA), Extended Activities of Daily Living (EADL), Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and Hospital Anxiety and Depression Scale-Depression (HADS-D), EuroQol-Health State (EQ-HS), EuroQol-Visual Analogue Scale (EQ-VAS), and Caregiver Strain Index (CSI) were administered. Patients were classified into 3 categories according to their Barthel Index (BI) score on admission to the rehabilitation center. Principal component analysis was carried out, and a biplot was constructed.
Data were available on 510 patients. One cluster was formed by RMA and EADL, and a second one by HADS-A, HADS-D, and EQ-VAS. EQ-HS was situated between these two. CSI formed a third dimension. Patients with low BI scores on admission to the rehabilitation center had higher HADS-A and HADS-D scores 6 months after stroke. High BI scores were associated with large variations in HADS-A and HADS-D scores.
This novel biplot strategy for rehabilitation studies revealed 2 clusters: one of motor/functional problems and one of emotional problems. Patients with mild functional deficit measured on admission to the rehabilitation center can suffer from mild to severe anxiety and depression at 6 months poststroke. Screening for emotional disorders in all patients is recommended.
本研究旨在通过调查卒中患者运动、功能和情感问题以及其照料者负担在卒中后6个月时的整体相关结构，揭示卒中结局的多维特征。分析了基于患者入住康复中心时功能水平的潜在差异关联。
数据收集于CERISE研究（欧洲卒中康复协作评估）。卒中后6个月，进行Rivermead运动评估（RMA）、日常生活活动扩展量表（EADL）、医院焦虑抑郁量表-焦虑分量表（HADS-A）、医院焦虑抑郁量表-抑郁分量表（HADS-D）、欧洲五维度健康量表（EQ-HS）、欧洲五维度视觉模拟量表（EQ-VAS）以及照料者负担指数（CSI）评定。根据患者入住康复中心时的Barthel指数（BI）评分将其分为3类。进行主成分分析并构建双标图。
510例患者有可用数据。RMA和EADL形成一个聚类，HADS-A、HADS-D和EQ-VAS形成另一个聚类。EQ-HS位于这两个聚类之间。CSI形成第三个维度。入住康复中心时BI评分低的患者在卒中后6个月时HADS-A和HADS-D评分较高。高BI评分与HADS-A和HADS-D评分的较大变化相关。
这种用于康复研究的新型双标图策略揭示了2个聚类：一个是运动/功能问题聚类，另一个是情感问题聚类。入住康复中心时功能轻度受损的患者在卒中后6个月时可能会出现轻度至重度焦虑和抑郁。建议对所有患者进行情感障碍筛查。
