Cohort Studies, COVID-19, Rehabilitation, Stroke
Conditions
Brief summary
COVID-19 has a big impact on individuals and society as a whole. Especially persons with (multiple) comorbidities such as stroke are affected. The impact of COVID-19 on stroke rehabilitation delivery and stroke patients' functioning is unclear.
Detailed description
With 16'000 patients hospitalized and with new permanent disability in approximately 7'000 individuals every year in Switzerland, stroke has a major impact on quality of life and is an enormous socioeconomic burden. Virtually all patients receive inpatient rehabilitation in the sub-acute phase poststroke. However, also in the later phases poststroke, patients receive rehabilitation interventions in outpatient rehabilitation clinics and private practices, with goal to improve or maintain their functional capacity. Currently, Switzerland finds itself in an extraordinary situation. The Federal Council has issued a series of measures aimed at the population, organizations and institutions, and the cantons. The aim is to curb the spread of the coronavirus and assure the provision of healthcare. The people are invoked to stay at home and only leave the home if absolutely necessary. If they are over the age of 65 or have an underlying medical condition, the Federal Council strongly recommend that you stay at home under any circumstances unless you have to go to the doctor. With the recommendation of the Swiss Federal Council almost all stroke patients belong to the group who should stay home. Furthermore, all outpatient rehabilitation clinics have reduced the interventions to a minimum. It is unknown how a sudden stop of rehabilitation influences the stroke patients' functional capacities and their perceived quality of life.
Interventions
BEHAVIORALObservation
Observation of intensity of rehabilitation therapy, daily life upper limb use, physical activi-ty engagement, patient-reported quality of life, and motor outcome after stroke
Sponsors
Jeremia Held
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Ischemic or haemorrhagic stroke, confirmed by MRI-DWI and/or CT * Participating in a stroke research project before the Lockdown (ESTREL - BASEC Nr. 2018-02021/ RE-USE - BASEC-Nr. 2017-01070) * Age 18 years or older * Verbal and written informed consent of the patient after participants' information
Exclusion criteria
* Severe communication or cognitive deficits, that cause inability to follow the procedures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rehabilitation data | 3 month after start lockdown | Nature of rehabilitation therapy, and number and duration of rehabilitation therapy sessions |
| Motor Activity Log - 14 Item Version | 3 month after start lockdown | Patient-reported upper limb use in daily life |
| International Physical Activity Questionnaire | 3 month after start lockdown | Patient-reported engagement in physical activity in daily life |
| Patient-Reported Outcomes Measurement Information System - 29 Version | 3 month after start lockdown | Patient-self-assessment comprising the following categories: 1) physical function, 2) anxiety, 3) depression, 4) fatigue, 5) sleep disturbance, 6) ability to participate in social roles and activities, 7) pain interference and 8) pain intensity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Ambulation Categories | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Classification regarding the ability to walk independently, with or without a walking aid and takes the type of walking surface into account |
| Ten-Meter Walk Test | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Gait speed and cadence |
| Rivermead Mobility Index | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Measures the ability of patients to make postural adjustments (e.g, move in bed), transfer (e.g. be-tween bed to chair), walk, and use stairs |
| Activities-specific Balance Confidence Scale | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Self-reported measure in which patients rate how confident they are in maintaining balance when performing 16 daily life tasks |
| Fugl-Meyer Motor Assessment | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Upper and lower limb motor function |
| Action Research Arm Test | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Upper limb capacity |
| Global Rating of Perceived Changes (physical activity engagement and upper limb use) | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Patient-reported global rating of physical activity engagement and upper limb use in daily life |
| National Institutes of Health Stroke Scale | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Neurological impairments |
| Rehabilitation data | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 6 months after lockdown | Nature of rehabilitation therapy, and number and duration of rehabilitation therapy sessions |
| Motor Activity Log - 14 Item Version | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 6 months after lockdown | Patient-reported upper limb use in daily life |
| International Physical Activity Questionnaire | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 6 months after lockdown | Patient-reported engagement in physical activity in daily life |
| Patient-Reported Outcomes Measurement Information System - 29 Version | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 6 months after lockdown | Patient-self-assessment comprising the following categories: 1) physical function, 2) anxiety, 3) depression, 4) fatigue, 5) sleep disturbance, 6) ability to participate in social roles and activities, 7) pain interference and 8) pain intensity |
| modified Rankin Scale | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Global disability |
| Fatigue Severity Scale | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Self-reported questionnaire regarding severity of fatigue and its influence on the performance of daily life activities |
| Hospital Anxiety and Depression Scale | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Depression and anxiety |
| Montreal Cognitive Assessment | 4 weeks after lockdown (extraordinary situation as defined by the Swiss law), 3 months after lockdown, 6 months after lockdown | Assesses cognitive functions |
Countries
Switzerland
Outcome results
None listed