Merve AKDENİZ LEBLEBİCİER, Dilan BULUT ÖZKAYA, Fatıma YAMAN

COVID-19 PANDEMİSİ SÜRECİNDE HEMİPLEJİ HASTALARINDA FONKSİYONELLİK, DEPRESYON VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ

AMAÇ: Bu çalışmada amaç, iskemik veya hemorajik inmeye bağlı hemipleji tanısı ile takipli hastalarda COVİD-19 pandemisi sırasında fonksiyonellik, duygu-durum ve yaşam kalitesindeki değişiklikleri araştırmaktır. GEREÇ VE YÖNTEM: COVID-19 pandemi döneminden önce inmeye bağlı hemipleji tanısı ile 30 seans rehabilitasyon tedavisi alan 83 hasta (ortalama yaş 62.0±6.43 yıl) çalışmaya dahil edildi. Katılımcıların yaş, cinsiyet, vücut kitle indeksi (VKİ), inme süresi, inme tipi, etkilenen taraf ve eğitim düzeyi ile ilgili veriler kaydedildi. Tüm değerlendirmeler COVID-19 pandemisinden önce yapıldı ve pandeminin başlamasından sonraki ilk yılda tekrarlandı. Hastaların fonksiyonel durumları Fonksiyonel Bağımsızlık Ölçütü (FIM) ile, depresyon düzeyleri Beck Depresyon Envanteri (BDI) kullanılarak, yaşam kaliteleri İnmeye Özgü Yaşam Kalitesi Ölçeği (SS-QOL) ile değerlendirildi. BULGULAR: COVID-19 öncesi ve pandeminin 1. yılında değerlendirilen hastaların FIM toplam puanlarında istatistiksel olarak anlamlı fark saptandı (91.32±15.94 ve 87.15±15.60, p<0.001). COVID-19 öncesi ve pandeminin 1. yılında hastaların FIM öz bakım skorları sırasıyla 27.45±6.62 ve 25.27±7.08, FIM sfinkter kontrol skorları sırasıyla 10.10±2.56 ve 9.39±2.87, FIM transfer puanları sırasıyla 14.67±3.36 ve 13.61±3.54, FIM sosyal algı puanları sırasıyla 18.40±1.86 ve 17.67±1.93 olarak saptandı (p<0.001). BDI skoru pandemi öncesi 10.06±3.18 ve pandeminin 1. yılında13.66±3.04, SS-QOL skorları pandemi öncesi 136.48±29.63 ve birinci yıl değerlendirmesinde 133.63±29.63 idi. (p<0.001). SONUÇ: COVID-19 pandemisi kronik hemiplejili hastalarda hem takip hem de rehabilitasyon tedavisinde gecikmelere neden olmuştur. Rehabilitasyon tedavisinden yoksun kalma ve sosyal izolasyon hastaların fonksiyonelliğini, yaşam kalitesini ve duygu durumunu etkilenmiştir.

Anahtar Kelimeler:

COVID-19 virüs, Hemipleji, Depresyon, Yaşam kalitesi

EVALUATION OF FUNCTIONALITY, DEPRESSION AND QUALITY OF LIFE IN HEMIPLEGIC PATIENTS DURING COVID-19 PANDEMIC

OBJECTIVE: The aim of this study was to investigate the changes of the functionality, mood and life quality of patients diagnosed with hemiplegia due to an ischemic or hemorrhagic stroke during the COVID-19 pandemic. MATERIAL AND METHODS: A total of 83 patients (mean age, 62.0±6.43 years) diagnosed with hemiplegia due to stroke, who received 30 sessions of rehabilitation therapy, before the COVID-19 pandemic, were included in this study. Data regarding the participants’ age, gender, body mass index (BMI), duration of stroke, stroke type, affected side, and education level were recorded. All the assessments were undertaken before the COVID-19 pandemic and repeated at the first year after the beginning of the pandemic. The functional status of the patients was evaluated with the Functional Independence Measure (FIM). The depression levels of the participants were evaluated using the Beck Depression Inventory (BDI). The life quality of the participants was evaluated using the Stroke-Specific Quality of Life Scale (SS-QOL). RESULTS: There were significant differences in the FIM total scores of the patients evaluated before and during COVID-19 (91.32±15.94 and 87.15±15.60, respectively, p<0.001).When the FIM domain scores were evaluated before COVID-19 and at the first-year control during COVID-19, the FIM self-care scores were 27.45±6.62 and 25.27±7.08, respectively, the FIM sphincter control scores were 10.10±2.56 and 9.39±2.87, respectively, the FIM transfers scores were 14.67±3.36 and 13.61±3.54, respectively, the FIM social cognition scores were 18.40±1.86 and 17.67±1.93 respectively (p<0.001). The BDI score was 10.06±3.18 before the pandemic and 13.66±3.04 at the first year of the pandemic, the SS-QOL scores was 136.48±29.63 before the pandemic and 133.63±29.63 at the first year evaluation (p<0.001). CONCLUSIONS: The COVID-19 pandemic has caused delays in both follow-up and rehabilitation therapy in patients with chronic hemiplegia. The functionality, life quality and mood of the patients have been affected due to the lack of therapy and social isolation.

Keywords:

COVID-19 virus, hemiplegia, depression, quality of life.,

PDF

___

1. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382 (13):1199-207.
2. WHO COVID-19 preparedness and response progress report. Available online at:https://www.who.int/publications/m/item/who-covid-19-preparedness-and-response-progress-report---1-february-to-30- june-2020 Accessed: October 15, 2020.
3. Douglas M, Katikireddi SV, Taulbut M, McKee M, McCartney G. Mitigating the wider health effects of COVID-19 pandemic response. BMJ. 2020;369:1557.
4. Mental health and psychosocial considerations during the COVID-19 outbreak. Available online at: https://www.who.int/publications/i/item/WHO-2019-nCoV-MentalHealth-2020.1 Accessed: October 14, 2020.
5.Yagcı I,Sarıkaya S, Ayhan F et al.The effects of COVID-19 on Physical Medicine and Rehabilitation inTurkey in the first month of pandemic. Turk J Phys Med Rehab. 2020;66(3):244-51.
6. Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet. 2011;14(9778):1693-702.
7. Nichols-Larsen DS, Clark PC, Zeringue A, et al. Factors influencing stroke survivors’ quality of life during subacute recovery. Stroke.2005;36(7):1480-4.
8. Hatem SM, Saussez G, Faille MD, et al. Rehabilitation of Motor Function after Stroke: A Multiple Systematic Review Focused on on Techniques to Stimulate Upper Extremity Recovery. Front Hum Neurosci. 2016;13(10):442.
9. Marotta N, Ammendolia A, Marinaro C, et al. International Classification of Functioning, Disability and Health (ICF) and correlation between disability and finance assets in chronic stroke patients. Acta Biomed. 2020;91(3): e2020064.
10. Koh GC-H, Hoenig H. How should the rehabilitation community prepare for 2019-nCoV? Arch Phys Med Rehabil. 2020;101(6):1068–71.
11. Smith EE, Mountain A, Hill MD et al. Canadian stroke best practice guidance during the COVID-19 pandemic. Can J Neurol Sci. 2020;47(4):474–8.
12. Phillips M, Turner-Stokes L, Wade D, Walton K. Rehabilitation in the wake of Covid-19 - A phoenix from the ashes. British Society of Rehabilitation Medicine, 2020. Available online at: https://www.bsrm.org.uk/downloads/covid-19bsrmissue1-published-27-4-2020.pdf .
13. Leira EC, Russman AN, Biller J, et al. Preserving stroke care during the COVID-19 pandemic: potential issues and solutions. Neurology. 2020;95(3):124–33.
14. Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. The reliability of the functional independence measure: A quantitative review. Arch Phys Med Rehabil. 1996;77(12):1226–32.
15. Küçükdeveci AA, Yavuzer G, Elhan AH, et al. Adaptation of the Functional Independence Measure for use in Turkey. ClinRehabil. 2001;15(3):311–9.
16. Hisli N. Beck Depresyon Ölçeği’nin bir Türk örnekleminde geçerlilik ve güvenilirliği. Psikoloji Dergisi. 1989; 23:3-13.
17. Hakverdioğlu-Yont G, Khorshıd L. İnmeye Özgü Yaşam Kalitesi Ölçeği' nin Türk toplumu için geçerlik ve güvenirliğinin incelenmesi. Doktora tezi. İzmir: Ege Üniversitesi Sağlık Bilimleri Üniversitesi, 2009.
18. Almhdawi KA, Jaber H, Alghwiri A, et al. Health-related quality of life and its correlates among individuals with stroke during the COVID-19 pandemic. Neuropsychol Rehabil. 2021;19;1-16.
19. Jin H, Hong C, Chen S, et al. Consensus for prevention and management of coronavirus disease 2019 (COVID-19) for neurologists. Stroke Vasc Neurol. 2020;5(2):146-51.
20. Grabowski DC, Joynt Maddox KE. Postacute care preparedness for COVID-19: thinking ahead. JAMA. 2020;323(20):2007-8.
21. Baracchini C, Pieroni A, Viero F. Acute stroke management pathway during Coronavirus-19 pandemic. Neu Sci. 2020;41(5):1003-5.
22. Atıcı A, Karamanlıoğlu AD, Öztürk G, et al. Rehabilitation Processes and Health Conditions of Patients with Stroke During COVID-19 Pandemic. J PMR Sci. 2022;25(1):34-41.
23. Rudolph AG, Sauri J, Carballo JL, et al. The impact of COVID-19 on community integration, quality of life, depression and anxiety in people with chronic spinal cord injury. J Spinal Cord Med. 2021;1:1-10.
24. Zhao L, Yang X, Yang F et al. Increased quality of life in patients with stroke during the COVID‑19 pandemic: a matched‑pair study. Sci Rep. 2021;11(1):10277.
25. Kahraman T. Korona virus hastalığı (COVID-19) pandemisi ve telerehabilitasyon. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2020;5(2): 87-92.
26. Ceylan A. Telerehabilitasyon yaklaşımları. Türkiye Klinikleri Sağlık Bilimleri Dergisi. 2020;5(3):354-60.