Date of Award

12-6-2022

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Ms. Yasmin Nadeem Parpio

Second Advisor

Dr Shafquat Rozi

Third Advisor

Dr Ayeesha Kamaal

Department

Community Health Sciences

Abstract

INTRODUCTION: Stroke is the world's second-greatest cause of mortality and the third reason for longterm disability with an average of 33 million stroke survivors. The burden of stroke is shifted to developing countries where at present, annually 4.85 million stroke deaths and 91.4 million disability-adjusted life years in developing countries while 1.6 million deaths and 21.5 million strokes-related DALYs in high-income countries are reported. Therefore, post-stroke physical rehabilitation provides the best chance to return to normal life as much as possible. However, the capacity of stroke rehabilitation professionals in further disciplines stays at a low level which highly impacts the quality of life.
METHOD: A hospital-based cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, Pakistan. A sample of 62 stroke survivors was obtained from neurologic consulting clinics using a purposive sampling technique. The stroke-specific quality of life score was assessed using the SS-QOL tool. The data was collected via a structured questionnaire using Google forms. Multiple Linear Regression was used to determine the association between physical rehabilitation and stroke-specific quality of life, controlling clinical and demographic factors of adult stroke survivors visiting tertiary care hospitals in Karachi, Pakistan.
RESULTS: The mean age of the participants was 55.3±1.83 years. Out of the total recruited participants, 59.6% of them were males. In 33.8% of the individuals exposed to physical rehabilitation, most of them were obese (47.6%) and 85.7% were diagnosed with ischemic stroke with a mean hospital stay of 7.3±6.83 days. Left upper limb weakness (39.1%) was the most reported weakness among this group. The mean SSQOL score for the physical rehabilitation group was 177±25.51. Contrarily, in 66.1% of the individuals with non-physical rehabilitation, most of them were overweight (41.46%) and 82.9% were diagnosed with ischemic stroke with a mean hospital stay of 4.9±3.57 days. Right lower limb weakness (46.3%) was the most reported weakness among this group. The mean SS-QOL score for the non-physical rehabilitation group was 172.2±32.12. The multivariable analysis showed that physical rehabilitation (β=1.79, 95% CI=-11.61,15.19), days of hospital admission from a recent stroke (β=1.60, 95% CI= 0.48,2.73), dysphagia (β=18.52, 95% CI= 6.19,30.85), impaired speech (β=14.7, 95% CI= 2.07,27.47) and limb therapy (β=- 22.2, 95% CI= -39.53, -4.88) was associated with the SS-QOL among stroke survivors.
CONCLUSION: The mean score of stroke-specific quality of life was higher for non-dysphagic and patients with no speech and memory impairment. Also, stroke survivors with no right upper limb weakness reported high mean SS-QOL scores. Therefore, a variety of post-stroke rehabilitation initiatives consisting of the multidisciplinary team is required for enhancing the physical, mental, and social quality of life of stroke survivors ensuring their return to an independent life. However, with the effort to overcome post-stroke rehabilitation challenges, a better quality-of-life score would become an achievable goal.

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1

Last Page

67

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