Norvang Ole Petter, Dahl Anne Eitrem, Thingstad Pernille, Askim Torunn
Department of Neuromedicine and Movement Science, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Clinical Services, Department of Physiotherapy, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Front Neurol. 2022 Jun 14;13:881621. doi: 10.3389/fneur.2022.881621. eCollection 2022.
Independence in basic activities of daily living (ADL) is an important outcome after stroke. Identifying factors associated with independence can contribute to improve post-stroke rehabilitation. Resilience, which is the ability of coping with a serious event, might be such a factor. Still, the impact of resilience and its role in rehabilitation after stroke is poorly investigated. Hence, the purpose of this study was to assess whether resilience assessed early after stroke can be associated with independence in basic ADL 3 months later. Hospitalized patients with a diagnosed acute stroke and a modified Rankin Scale score ≤ 4 were included. Bivariate and multivariate linear regression were applied to assess whether resilience as measured by the Brief Resilience Scale within the first 2 weeks after stroke was associated with basic ADL measured by Barthel Index at 3-month follow-up. Age, sex, fatigue, stroke severity at admission and pre-stroke disability were added as covariates. Sixty-four participants (35 (54.7%) male), aged 75.9 (SD 8.6) years were included 4.3 (SD 2.8) days after stroke. There was no significant change in resilience from baseline 3.1 (SD 0.3) to 3 months later 3.2 (SD 0.5). Resilience was not associated with basic ADL in neither the bivariate (b = 2.01, 95% CI -5.21, 9.23, = 0.580) nor in the multivariate regression models (b = 0.50, 95% CI -4.87, 6.88, = 0.853). Our results showed that resilience remained stable during follow-up. Early measurement of resilience was not associated with independence in basic activities of daily living 3 months after stroke. These results, indicate that resilience is a personal trait not associated with the outcome of physical adversity. However, future research should investigate whether resilience is related to the outcomes of psychosocial adversity after a stroke.
日常生活基本活动（ADL）的独立性是中风后的一项重要预后指标。识别与独立性相关的因素有助于改善中风后的康复情况。心理弹性，即应对严重事件的能力，可能是这样一个因素。然而，心理弹性对中风康复的影响及其在康复中的作用仍未得到充分研究。因此，本研究的目的是评估中风后早期评估的心理弹性是否与3个月后基本ADL的独立性相关。纳入了诊断为急性中风且改良Rankin量表评分≤4的住院患者。采用双变量和多变量线性回归来评估中风后前2周内通过简易心理弹性量表测量的心理弹性是否与3个月随访时通过Barthel指数测量的基本ADL相关。将年龄、性别、疲劳、入院时的中风严重程度和中风前残疾作为协变量纳入分析。64名参与者（35名（54.7%）男性），年龄为75.9（标准差8.6）岁，在中风后4.3（标准差2.8）天被纳入研究。从基线时的3.1（标准差0.3）到3个月后的3.2（标准差0.5），心理弹性没有显著变化。在双变量回归模型（b = 2.01，95%置信区间 -5.21，9.23，P = 0.580）和多变量回归模型（b = 0.50，95%置信区间 -4.87，6.88，P = 0.853）中，心理弹性均与基本ADL无关。我们的结果表明，在随访期间心理弹性保持稳定。中风后早期测量的心理弹性与3个月后日常生活基本活动的独立性无关。这些结果表明，心理弹性是一种个人特质，与身体逆境的结果无关。然而，未来的研究应该调查心理弹性是否与中风后心理社会逆境的结果相关。
