| 소속 |
Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute1, School of Medicine, Chungnam National University, Department of Rehabilitation Medicine2, Konkuk University School of Medicine, Department of Rehabilitation Medicine3, Yonsei University College of Medicine, Department and Research Institute of Rehabilitation Medicine4, Chonnam National University Medical School, Department of Physical and Rehabilitation Medicine5, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Department of 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 Prevention 14, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea, Department of Health Sciences and Technology, Department of Medical Device Management and Research , Department of Digital Health15 |
| 저자 |
Kyou Hyun Kim1*, Min Kyun Sohn2, Jongmin Lee3, Deog Young Kim4, Sam-Gyu Lee5, Yong-Il Shin6, Gyung-Jae Oh7, Yang-Soo Lee8, Min Cheol Joo9, So Young Lee10, Junhee Han11, Jeonghoon Ahn12, Young-Hoon Lee7, Won Hyuk Chang2, Sung Hyun Kang13, Ji-Yoo Choi13, Young Taek Kim14, Yun-Hee Kim1,15† |
Objective: There is no definite consensus to the course of long-term functional level in stroke patients after 6 months of stroke onset. The purpose of this study was to analyze the functional recovery patterns from 7 days to 3 year after stroke onset and the time point to reach the plateau and decline of diverse aspect of function for 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 7,858 patients who agreed with participation, 4,722 patients completed face-to-face assessments at 3 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 patients separately and also for subsets grouped by their baseline stroke severities.
Results: Among 4,722 patients, 79.7% of patients suffered from ischemic and 20.7% hemorrhagic stroke, respectively. Their mean age was 63.0 years and the ratio of male to female was 1.44. 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, FMA, and FAC reached to the plateau at 12 months after stroke onset and showed the decline from 24 months after stroke onset.
Conclusion: The results of this study demonstrated long-term functional recovery and declining pattern according to initial severity and different functional categories in the first-ever stroke patients. Proper rehabilitation strategies should be considered in chronic stroke patients to maintain their functional level |
