Perfil de atividade e participação social após a alta hospitalar de sobreviventes de AVC e fatores associados

Abstract

Introduction: Limitations in performing activities and social responsibilities are the main difficulties faced by stroke survivors after discharge from hospital. Objective: To describe the types of activities and social interactions after hospital discharge of stroke survivors and associated factors. Material and methods: This is a longitudinal study of individuals in the subacute phase after suffering a stroke, who were admitted to a public hospital with a well-regarded neurological division located in Salvador, Bahia, Brazil. The primary data assessed during hospitalization were stroke severity, postural control, functional disability, thoracic mobility, respiratory muscle strength and coughing ability. Secondary data were extracted from medical records and the outcomes, activities and social interactions were investigated six months after discharge. Linear regression analysis and Pearson's correlation were performed. The study was approved under protocol 4.982.188 and CAEE 15885919.2.0000.5028. Results: The sample consisted of 50 volunteers, with an average age of 58±12 years, 27 (54%) were female, 30 (60%) and worked in some capacity, the average NIHSS scale was 5±4, the average length of stay was 20±13 days, 42 (84%) with ischemic type stroke and 11 (22%) thrombolyzed. Several 21 (45%) had incomplete muscle strength on the left (hemiparesis) and 8 (16%) had heminegligence. The average PASS scale was 23±10 and 18 (60%) of the individuals had an average score of between 3-5 on the ERM scale, resulting in moderate kinetic-functional impairment. In terms of respiratory function, the variation in umbilical cirtometry (2.4 ±5.0) was the most significant, MIP (53±31) and MEP (52±35) measurements were below the predicted values, the average TFP was 165 ± 92 and there was a moderate to good correlation between MEP and TFP (r=0.52 p= 0.005). The lowest average score on the LIFE-H scale was attributed to the social interactions (2.93±0.6) compared to activity (3.58±0.3). The explanatory variables showed no correlation with the outcomes investigated. Conclusion: Stroke survivors showed a marked decline in activity and social interaction after hospital discharge, with the greatest impairment in social roles. In addition, individuals showed a decline in thoracic mobility, respiratory muscle strength, coughing ability, postural control and functional capacity during hospitalization.