Choi JH, et al. Ann Rehabil Med. 2014 Aug;38(4):485-493. http://dx.doi.org/10.5535/arm.2014.38.4.485

Development of a long-term stroke care plan requires serial assessment of long-term patient function and consideration of caregiver mood. However, to date, few comprehensive cohort studies have included both stroke patients and caregivers. KOSCO is a large, multi-centre prospective cohort study for all acute first-ever stroke patients admitted to participating hospitals in nine distinct areas of Korea. This study is designed as a 10-year, longitudinal follow-up investigating the residual disabilities, activity limitations, and quality of life issues arising in patients suffering from first-ever stroke. The main objectives of this study are to identify the factors that influence residual disability and long-term quality of life. The secondary objectives of this study are to determine the risk of mortality and recurrent vascular events in patients with acute first-ever stroke. We will investigate longitudinal health behaviors and patterns of healthcare utilization, including stroke rehabilitation care. We will also investigate the long-term health status, mood, and quality of life in stroke patient caregivers. In addition, we will identify baseline and ongoing characteristics that are associated with our secondary outcomes. KOSCO is a prospective, multi-centre, 10-year longitudinal follow-up study investigating the residual disabilities, activity limitations, and quality of life issues arising in patients suffering from first-ever stroke.

To determine the incidence and risk factors for medical complications in Korean patients suffering from stroke and the impact of such complications on post-stroke functional outcomes. We assessed patients enrolled in a prospective cohort study. All recruited patients had suffered a first acute stroke episode and been admitted to nine university hospitals in Korea between August 2012 and June 2015. We analyzed patient and stroke characteristics, comorbidities, prevalence of post-stroke medical complications, and functional outcomes at time of discharge and 3, 6, and 12 months after stroke onset. Of 10,625 patients with acute stroke, 2,210 (20.8%) presented with medical complications including bladder dysfunction, bowel dysfunction, sleep disturbance, pneumonia, and urinary tract infection. In particular, complications occurred more frequently in older patients and in patients with hemorrhagic strokes, more co-morbidities, severe initial motor impairment, or poor swallowing function. In-hospital medical complications were significantly correlated with poor functional outcomes at all time points. Post-stroke medical complications affect functional recovery. The majority of complications are preventable and treatable; therefore, the functional outcomes of patients with stroke can be improved by providing timely, appropriate care. Special care should be provided to elderly patients with comorbid risk factors.

Kim C, et al. Korean Circ J. 2018 Aug;49:e129. https://doi.org/10.4070/kcj.2019.0194

Lee SY, et al. Ann Rehabil Med. 2013 Oct;37(5):619-627. http://dx.doi.org/10.5535/arm.2013.37.5.619

Purpose: To investigate the correlation between baseline cardiovascular fitness and functional status, and whether baseline cardiovascular fitness is of predictive value in terms of functional recovery after rehabilitation in subacute stroke patients. Method: This study was a descriptive, observational cohort study. Fifty-five subacute stroke patients (37 males and 18 females; average age, 62.2 years) were enrolled for this study, and all subjects underwent symptomlimited low-velocity graded treadmill testing. Baseline assessments included cardiovascular fitness, 6-min walk test (6MWT), Korean-Modified Barthel Index (K-MBI) and Motricity Index (MI). Four weeks after rehabilitation, K-MBI was measured repeatedly. Results: Mean peak oxygen consumption (Vo2 peak) was 19.7 +/- 6.7 mL/kg/min. Baseline K-MBI correlated significantly with Vo(2) peak, peak heart rate (HR), 6MWT and MI, and in regression analysis, Vo(2) peak and MI were significant independent predictors of baseline K-MBI. Follow-up K-MBI correlated significantly with Vo(2) peak, peak HR, peak rate pressure product, 6MWT, baseline K-MBI and MI, and in linear regression analysis, Vo(2) peak and baseline K-MBI were significant independent predictors of follow-up K-MBI. Conclusion: These results indicate that baseline cardiovascular fitness correlates significantly with the baseline functional status, in addition to being an important prognostic factor regarding the functional recovery of subacute stroke patients.