| 제목 |
Functional Recovery Patterns from 7 Day to 2 Year after the First Strokes in Korea: The KOSCO study |
| 소속 |
Pusan National University School of Medicine, Pusan National University Yangsan Hospital , Department of Rehabilitation Medicine1, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Physical and Rehabilitation Medicine2, School of Medicine, Chungnam National University, Department of Rehabilitation Medicine3, Konkuk University School of Medicine, Department of Rehabilitation Medicine4, Yonsei University College of Medicine, Department and Research Institute of Rehabilitation Medicine5, Chonnam National University Medical School, Department of Physical and Rehabilitation Medicine6, Wonkwang University, School of Medicine, Department of Preventive Medicine7, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Department of Rehabilitation Medicine8, Wonkwang University School of Medicine, Department of Rehabilitation Medicine9, Jeju National University Hospital, Jeju National University School of Medicine, Department of Rehabilitation Medicine10, Hallym University, Department of Statistics11, Ewha Womans University, Department of Health Convergence12, Korea Centers for Disease Control and Prevention, Division of Chronic Disease Prevention, Center for Disease13, Korea Centers for Disease Control and Prevention, Division of Chronic Disease Control, Center for Disease Prevention14, Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Department of Health Science and Technology15 |
| 저자 |
Yong-Il Shin1, Won Hyuk Chang2, Min Kyun Sohn3, Jongmin Lee4, Deog Young Kim5, Sam-Gyu Lee6, Gyung-Jae Oh7, Yang-Soo Lee8, Min Cheol Joo9, Eun Young Han10, Junhee Han11, Jeonghoon Ahn12, Young-Hoon Lee7, Min A Shin2, Sang Moon Yun2*, Sung Hyun Kang13, Yong-Joo Choi13, Kang Hee Lee13, Young Taek Kim14, Yun-Hee Kim2,15† |
Objective: There is no definite consensus to when the recovery of stroke function is stagnant, although it is some reports that the activities of daily living and the motor function are 6 months. The purpose of this study was to analyze the functional recovery patterns from 7 days to 2 year after stroke onset and the time point to reach the plateau of each function for the total, ischemic and hemorrhagic stroke.
Materials and Methods: This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) designed as 10 years long-term follow-up study of stroke patients. All patients who admitted to the representative hospitals in 9 distinct areas of Korea with their acute first-ever stroke (from August 2012 to May 2015) were recruited. Both ischemic and hemorrhagic strokes were included but transient ischemic attacks were excluded. Out of 8,010 patients who agreed with participation, 4,909 patients completed face-to-face assessments at 2 year after stroke onset. Functional assessments included Korean modified Barthel Index (K-MBI), Korean Mini-Mental State Examination (K-MMSE), Fugl-Meyer Assessment (FMA), Functional Ambulatory Category (FAC), the American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale (ASHA-NOMS), and Short Korean Version of Frenchay Aphasia Screening Test (Short K-FAST). We demonstrated the each functional recovery pattern for total, ischemic and hemorrhagic stroke data separately and also for subsets grouped by their baseline stroke severities.
Results: Among 4,909 patients, 79.7% of patients suffered from ischemic and 20.3% hemorrhagic stroke, respectively. Their mean age was 63.8 years and the ratio of male to female was 1.45. Table 1 shows the distribution of the clinical characteristics by stroke type. The multi-facet functional recovery patterns in first-ever stroke patients were different according to the baseline stroke severity. RMANOVA showed a significant interaction effect between time and baseline stroke severity) in K-MBI, FMA, K-MMSE, FAC, ASHA-NOMS, Short K-FAST (P<0.05). K-MBI reached to the plateau at 18 months after ischemic stroke onset in the mild group; however, K-MBI reached to the plateau at 12 months after ischemic stroke onset in the moderate and severe group.
Conclusion: The results of this study demonstrated that functional recovery should be expected after the first 6 months in the first-ever stroke patients. In addition, the present study showed that there were different recovery patterns according to functional domain and severity at acute phase in stroke patient |
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Table 1. Distribution of general and clinical patient characteristics
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