Recovery from poststroke visual impairment: evidence from a clinical trials resource
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Recovery from poststroke visual impairment: evidence from a clinical trials resource. / Ali, Myzoon; Hazelton, Christine; Lyden, Patrick; Pollock, Alex; Brady, Marian; VISTA Collaboration.
in: NEUROREHAB NEURAL RE, Jahrgang 27, Nr. 2, 01.02.2013, S. 133-41.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Recovery from poststroke visual impairment: evidence from a clinical trials resource
AU - Ali, Myzoon
AU - Hazelton, Christine
AU - Lyden, Patrick
AU - Pollock, Alex
AU - Brady, Marian
AU - VISTA Collaboration
AU - Thomalla, Götz
PY - 2013/2/1
Y1 - 2013/2/1
N2 - INTRODUCTION: Limited evidence suggests that visual impairments may influence outcome after stroke. The degree of recovery from these impairments is poorly characterized.OBJECTIVES: To describe recovery and to determine whether visual impairments influence functional outcome and quality of life.METHODS: We extracted demographic and outcome data from the Virtual International Stroke Trials Archive (VISTA). We examined horizontal eye movement disorders and hemianopia using the Best Gaze and Visual domains of the National Institutes of Health Stroke Scale (NIHSS) and described recovery at 30 and 90 days. Proportional odds modelling was used to examine the association between impairments at baseline, modified Rankin Scale (mRS), and European Quality of Life Score (EQ-5D) at 90 days.RESULTS: Visual impairments were reported in 7,204/11,900 (60.5%) patients at baseline. Complete recovery occurred in 1,398/3,285 (42.6%) and 3,243/7,204 (45.0%) patients by 30 and 90 days respectively. The burden of persistent visual impairment in survivors was 1,135/4,028 (28.2%) at 30 days and 1,915/9,338 (20.5%) at 90 days. Partial gaze palsy (P < .0001; OR = 0.81; 95% CI = 0.74-0.87), forced deviation (P < .0001; OR = 0.48; 95% CI = 0.43-0.53), and complete homonymous hemianopia (P < .0001; OR = 0.67; 95% CI = 0.62-0.73) at baseline were associated with poor mRS at 90 days.CONCLUSIONS: The rate of recovery was greater in the first month after stroke, suggesting a potential time frame for interventions. The associations between visual impairments and poor mRS suggest that these impairments should be considered in multidisciplinary assessments and interventions.
AB - INTRODUCTION: Limited evidence suggests that visual impairments may influence outcome after stroke. The degree of recovery from these impairments is poorly characterized.OBJECTIVES: To describe recovery and to determine whether visual impairments influence functional outcome and quality of life.METHODS: We extracted demographic and outcome data from the Virtual International Stroke Trials Archive (VISTA). We examined horizontal eye movement disorders and hemianopia using the Best Gaze and Visual domains of the National Institutes of Health Stroke Scale (NIHSS) and described recovery at 30 and 90 days. Proportional odds modelling was used to examine the association between impairments at baseline, modified Rankin Scale (mRS), and European Quality of Life Score (EQ-5D) at 90 days.RESULTS: Visual impairments were reported in 7,204/11,900 (60.5%) patients at baseline. Complete recovery occurred in 1,398/3,285 (42.6%) and 3,243/7,204 (45.0%) patients by 30 and 90 days respectively. The burden of persistent visual impairment in survivors was 1,135/4,028 (28.2%) at 30 days and 1,915/9,338 (20.5%) at 90 days. Partial gaze palsy (P < .0001; OR = 0.81; 95% CI = 0.74-0.87), forced deviation (P < .0001; OR = 0.48; 95% CI = 0.43-0.53), and complete homonymous hemianopia (P < .0001; OR = 0.67; 95% CI = 0.62-0.73) at baseline were associated with poor mRS at 90 days.CONCLUSIONS: The rate of recovery was greater in the first month after stroke, suggesting a potential time frame for interventions. The associations between visual impairments and poor mRS suggest that these impairments should be considered in multidisciplinary assessments and interventions.
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Quality of Life
KW - Recovery of Function
KW - Severity of Illness Index
KW - Stroke
KW - Time Factors
KW - Treatment Outcome
KW - Virtual Reality Exposure Therapy
KW - Vision Disorders
U2 - 10.1177/1545968312454683
DO - 10.1177/1545968312454683
M3 - SCORING: Journal article
C2 - 22961263
VL - 27
SP - 133
EP - 141
JO - NEUROREHAB NEURAL RE
JF - NEUROREHAB NEURAL RE
SN - 1545-9683
IS - 2
ER -