Department of Psychiatry, Faculty of Medicine, Near East University, Nicosia, Cyprus.
Department of Physical Medicine and Rehabilitation, Famagusta State Hospital, Famagusta, Cyprus.
J Stroke Cerebrovasc Dis. 2019 Nov;28(11):104349. doi: 10.1016/j.jstrokecerebrovasdis.2019.104349. Epub 2019 Sep 3.
Sleep disorders are more prevalent in patients with previous stroke compared to healthy individuals. The main objective of the present study was to investigate the impact of sleep quality on the functional status of patients with a history of stroke, upon admission to inpatient rehabilitation.
Fifty patients (mean age: 69 ± 11 years) with previous stroke were consecutively included in this single center cross-sectional observational study upon admission to inpatient rehabilitation. Pittsburgh Sleep Questionnaire Index (PSQI) was calculated for all patients and patients were divided into 2 groups according to PSQI scores (PSQI ≤ 5 as good sleepers and PSQI > 5 as poor sleepers). A specialist evaluated the level of muscle spasticity and disability, walking capability, and overall performance of daily activity of all enrolled patients using the functional ambulation scale (FAS) score, modified Brunnstrom Classification, Modified Ashworth scale, and Beck Depression Inventory.
The FAS score (3.4 ± 1.3 versus 1.8 ± 1.7, P = .004) and Brunnstrom scores of upper limb (3.8 ± 1.1 versus 2.5 ± 1.6, P = .005), lower limb (4.3 ± 1.4 versus 3.1 ± 1.7, P = .013) and hand (3.6 ± 1.5 versus 2.3 ± 1.6, P = .006) were significantly higher in good sleepers than poor sleepers. Linear regression analysis revealed that PSQI score (coefficient β = -.360, 95% CI: -.212-.032, P = .009) and age (coefficient β = -.291, 95% CI: .100-.245, P = .032) were independently associated with FAS score.
Results of the present study indicate that presence of poor sleep quality is associated with poor functional status which might further impair the outcomes of the rehabilitation and accordingly the health-related quality of life in patients admitted for stroke rehabilitation.
与健康个体相比，既往卒中患者更常患有睡眠障碍。本研究的主要目的是调查睡眠质量对入院接受住院康复治疗的既往卒中患者的功能状态的影响。
本单中心横断面观察性研究连续纳入 50 例（平均年龄：69 ± 11 岁）既往卒中患者，在入院接受住院康复治疗时，对所有患者进行匹兹堡睡眠质量指数（PSQI）评分，并根据 PSQI 评分将患者分为 2 组（PSQI≤5 分为睡眠良好者，PSQI＞5 分为睡眠不良者）。一位专家使用功能性步行量表（FAS）评分、改良 Brunnstrom 分类、改良 Ashworth 量表和贝克抑郁量表评估所有入组患者的肌肉痉挛程度和残疾程度、步行能力以及日常活动的整体表现。
与睡眠不良者相比，睡眠良好者的 FAS 评分（3.4 ± 1.3 比 1.8 ± 1.7，P =.004）和上肢 Brunnstrom 评分（3.8 ± 1.1 比 2.5 ± 1.6，P =.005）、下肢 Brunnstrom 评分（4.3 ± 1.4 比 3.1 ± 1.7，P =.013）和手 Brunnstrom 评分（3.6 ± 1.5 比 2.3 ± 1.6，P =.006）更高。线性回归分析显示，PSQI 评分（系数β=-.360，95%CI：-.212-.032，P=.009）和年龄（系数β=-.291，95%CI：.100-.245，P=.032）与 FAS 评分独立相关。
本研究结果表明，睡眠质量差与功能状态差有关，这可能进一步影响康复治疗的结果，并因此影响入院进行卒中康复治疗患者的健康相关生活质量。
