Correlación entre deficiencia, afectación psicológica, discapacidad y calidad de vida en la parálisis facial periférica / Correlations between impairment, psychological distress, disability, and quality of life in peripheral facial palsy

Introducción: El objetivo de este trabajo es analizar la correlación entre escalas de deficiencia, afectación psicológica, discapacidad y calidad de vida en personas que han sufrido una parálisis facial periférica (PFP). Material y métodos: Se realizó un estudio transversal retrospectivo con 30 pacientes que habían presentado una PFP cuya resolución fue incompleta. Se utilizaron cuestionarios de deficiencia (Sunnybrook Facial Grading System [FGS]), afectación psicológica (Hospital Anxiety and Depression Scale [HADS]), discapacidad (Facial Disability Index [FDI]) y calidad de vida (Facial Clinimetric Evaluation Scale [FaCE]). Resultados: No encontramos correlación entre FGS y HADS, ni entre FGS y FDI Social. Existe correlación entre FGS y FDI Física (r = 0,54; p < 0,01), FDI total (r = 0,4; p < 0,05), FaCE total (ρ = 0,66; p < 0,01) y FaCE Social (ρ = 0,5;p < 0,01). Observamos correlación entre HADS Ansiedad y FDI Física (r = -0,47; p < 0,01), FDI Social (r = -0,47; p < 0,01), FDI Total (r = -0,55; p < 0,01), FaCE Total (ρ = -0,49; p < 0,01) y FaCE Social (ρ = -0,46; p < 0,05). También entre HADS Depresión y FDI Física (r=-0,61; p < 0,01), FDI Social (r=-0,53; p < 0,01), FDI Total (r = -0,66; p < 0,01), FaCE Total (ρ = -0,67; p < 0,01) y FaCE Social (ρ = -0,68; p < 0,01). Encontramos correlación entre FDI Física y FaCE Total (ρ = 0,87; p < 0,01) y FaCE Social (ρ = 0,74; p < 0,01), FDI Social y FaCE Total (ρ = 0,66; p < 0,01) y FaCE Social (ρ = 0,72; p < 0,01), y FDI Total y FaCE Total (ρ = 0,87; p < 0,01) y FaCE Social (ρ = 0,84; p < 0,01). Conclusión: En nuestro grupo de estudio, los pacientes con mayor déficit presentan mayor discapacidad física y global y peor calidad de vida, aunque no mayor discapacidad social ni mayor afectación psicológica. Los pacientes con mayor discapacidad presentan mayor afectación psicológica y peor calidad de vida. Los pacientes con mayor afectación psicológica presentan peor calidad de vida

Introduction: This paper analyses the correlations between scores on scales assessing impairment, psychological distress, disability, and quality of life in patients with peripheral facial palsy (PFP). Material and methods: We conducted a retrospective cross-sectional study including 30 patients in whom PFP had not resolved completely. We used tools for assessing impairment (Sunnybrook Facial Grading System [FGS]), psychological distress (Hospital Anxiety and Depression Scale [HADS]), disability (Facial Disability Index [FDI]), and quality of life (Facial Clinimetric Evaluation [FaCE] scale). Results: We found no correlations between FGS and HADS scores, or between FGS and FDI social function scores. However, we did find a correlation between FGS and FDI physical function scores (r = 0.54; P < .01), FDI total score (r=0.4; P < .05), FaCE total scores (ρ = 0.66; P < .01), and FaCE social function scores (ρ=0.5; P < .01). We also observed a correlation between HADS Anxiety scores and FDI physical function (r = -0.47; P < .01), FDI social function (r = -0.47; P < .01), FDI total (r = -0.55; P < .01), FaCE total (ρ= - 0.49; P < .01), and FaCE social scores (ρ = -0.46; P < .05). Significant correlations were also found between HADS Depression scores and FDI physical function (r = - 0.61; P < .01), FDI social function (r = -0.53; P < .01), FDI total (r = - 0.66; P < .01), FaCE total (ρ = - 0.67; P < .01), and FaCE social scores (ρ = -0.68; P < .01), between FDI physical function scores and FaCE total scores (ρ = 0.87; P < .01) and FaCE social function (ρ = 0.74; P < .01), between FDI social function and FaCE total (ρ = 0.66; P < .01) and FaCE social function scores (ρ = 0.72; P < .01), and between FDI total scores and FaCE total (ρ = 0,87; P < .01) and FaCE social function scores (ρ = 0.84; P < .01). Conclusion: In our sample, patients with more severe impairment displayed greater physical and global disability and poorer quality of life without significantly higher levels of social disability and psychological distress. Patients with more disability experienced greater psychological distress and had a poorer quality of life. Lastly, patients with more psychological distress also had a poorer quality of life

Correlations between impairment, psychological distress, disability, and quality of life in peripheral facial palsy. / Correlación entre deficiencia, afectación psicológica, discapacidad y calidad de vida en la parálisis facial periférica.

INTRODUCTION: This paper analyses the correlations between scores on scales assessing impairment, psychological distress, disability, and quality of life in patients with peripheral facial palsy (PFP). MATERIAL AND METHODS: We conducted a retrospective cross-sectional study including 30 patients in whom PFP had not resolved completely. We used tools for assessing impairment (Sunnybrook Facial Grading System [FGS]), psychological distress (Hospital Anxiety and Depression Scale [HADS]), disability (Facial Disability Index [FDI]), and quality of life (Facial Clinimetric Evaluation [FaCE] scale). RESULTS: We found no correlations between FGS and HADS scores, or between FGS and FDI social function scores. However, we did find a correlation between FGS and FDI physical function scores (r=0.54; P<.01), FDI total score (r=0.4; P<.05), FaCE total scores (ρ=0.66; P<.01), and FaCE social function scores (ρ=0.5; P<.01). We also observed a correlation between HADS Anxiety scores and FDI physical function (r=-0.47; P<.01), FDI social function (r=-0.47; P<.01), FDI total (r=-0.55; P<.01), FaCE total (ρ=-0.49; P<.01), and FaCE social scores (ρ=-0.46; P<.05). Significant correlations were also found between HADS Depression scores and FDI physical function (r=-0.61; P<.01), FDI social function (r=-0.53; P<.01), FDI total (r=-0.66; P<.01), FaCE total (ρ=-0.67; P<.01), and FaCE social scores (ρ=-0.68; P<.01), between FDI physical function scores and FaCE total scores (ρ=0.87; P<.01) and FaCE social function (ρ=0.74; P<.01), between FDI social function and FaCE total (ρ=0.66; P<.01) and FaCE social function scores (ρ=0.72; P<.01), and between FDI total scores and FaCE total (ρ = 0,87; P<.01) and FaCE social function scores (ρ=0.84; P<.01). CONCLUSION: In our sample, patients with more severe impairment displayed greater physical and global disability and poorer quality of life without significantly higher levels of social disability and psychological distress. Patients with more disability experienced greater psychological distress and had a poorer quality of life. Lastly, patients with more psychological distress also had a poorer quality of life.

Análisis de los factores que influyen en la afectación psicológica, la capacidad funcional y la calidad de vida en pacientes con parálisis facial periférica / Analysis of factors contributing to psychological distress, functional capacity and quality of life in patients with peripheral facial palsy

Introducción y objetivos. El objetivo de este trabajo es analizar diferentes factores que pueden influir en la afectación psicológica, la capacidad funcional y la calidad de vida en personas que han sufrido una parálisis facial periférica (PFP) no resuelta completamente. Material y métodos. Se realizó un estudio transversal retrospectivo con 31 pacientes que habían sufrido una PFP cuya resolución fue incompleta. Los factores analizados fueron: severidad, edad, sexo, lateralidad, etiología, grado de lesión inicial del nervio, tiempo de evolución, estado civil y ocupación laboral. Se utilizaron cuestionarios de afectación psicológica (Escala de Ansiedad y Depresión Hospitalaria [HADS]), discapacidad (Índice de Discapacidad Facial [FDI]) y calidad de vida (Facial Clinimetric Evaluation Scale [FaCE]). Resultados. El factor más relevante fue la severidad, con correlaciones estadísticamente significativas con el FaCE total (r=0,596; p<0,01), el FaCE social (r=0,444; p<0,05), el FDI física (r=0,539; p<0,01), y el FDI total (r=0,395; p<0,05). La edad se correlacionaba con el FDI social (r=0,36; p<0,05). Los que tenían pareja presentaban mayor discapacidad, con diferencias de medias estadísticamente significativas en el FDI física (p<0,01) y el FDI total (p<0,01). Trabajar de cara al público asociaba una peor calidad de vida, con diferencias estadísticamente significativas en el FaCE total (p<0,05). Conclusión. La severidad de la PFP tiene una correlación directa con la discapacidad y la calidad de vida. La edad influye en la discapacidad social. El estado civil se asocia con la discapacidad y el trabajo con la calidad de vida. La influencia del resto de factores es poco relevante (AU)

Introduction and objectives. The aim of this study was to analyse various factors that can contribute to psychological distress, functional capacity and quality of life in people with incompletely resolved peripheral facial palsy (PFP). Material and methods. We performed a retrospective cross-sectional study in 31 patients with incompletely resolved PFP. The factors analysed were: severity, age, gender, laterality, aetiology, degree of initial nerve injury, duration, marital status and occupation. Psychological distress was assessed through the Hospital Anxiety and Depression Scale (HADS), disability through the Facial Disability Index (FDI) and quality of life through the Facial Clinimetric Evaluation Scale (FaCE) questionnaires. Results. The most important factor was severity, with statistically significant correlations with FaCE Total (r=0.596; p<0.01), FaCE Social (r=0.444; p<0.05), FDI Physical (r=0.539; p<0.01), and FDI Total (r=0.395; p<0.05). Age was correlated with FDI Social (r=0.36; p<0.05). Patients with a partner showed more disability, with statistically significant differences in mean scores of FDI Physical (p<0.01) and FDI Total (p<0.01). Working with the public was associated with lower quality of life, with statistically significant differences in FaCE Total (p<0.05). Conclusion. The severity of PFP is directly correlated with disability and quality of life. Age influences social disability. Marital status is associated with disability and occupation with quality of life. The other factors studied had little influence (AU)

Resultados y eficiencia del tratamiento rehabilitador del hemipléjico. Estudio evolutivo / Results and efficiency of the stroke medical rehabilitation treatment. Evolutive study

Introducción: El análisis de la eficiencia del tratamiento rehabilitador del accidente vascular cerebral tiene especial importancia por tratarse de una patología invalidante que requiere tratamientos prolongados y cuyo resultado depende no sólo de las características propias de la lesión sufrida, sino también de la estructura disponible, que condiciona el tipo e intensidad del tratamiento de rehabilitación. Objetivo: Se analiza el resultado y la eficiencia del tratamiento rehabilitador del hemipléjico agudo en régimen hospitalario durante los períodos 2002–2007 (P02-07) y 1994–2001 (P94-01). Pacientes y método: Se realiza el estudio de una cohorte de casos consecutivos de pacientes que sufrieron un accidente vascular cerebral entre el 1-01-2002 y el 31-12-2007 e ingresaron en el servicio de rehabilitación para tratamiento. Se mide la situación funcional por medio del Functional Independence Measure (FIM) al ingreso y al alta. La eficiencia fue considerada como el cociente entre ganancia y estancia. Se construye el patrón de resultados y la matriz de eficiencia de Stineman. Se compara la eficiencia, el patrón de resultados y la matriz de eficiencia de este período (2002–2007) con el de 1994 a 2001. Resultados Los pacientes del P02-07 (129 pacientes) son de menor edad que los del P94-01 (247 pacientes) (63,5 vs. 69,1; intervalo de confianza [IC] 95%: 3,2–8,1), tienen un FIM al alta similar (76,9 y 76,8), las ganancias (27,3 vs. 33,7; IC95%: 2,1–10,5) y las estancias (29,3 vs. 36,7; IC95%: 0,7–13) son inferiores, y la eficiencia es similar (1,5 y 1,4) en ambos períodos. No hay diferencias entre los patrones de resultados, aunque el percentil 75 es inferior en el P02-07 (96 vs. 103). Las matrices de eficiencia se diferencian en el grupo v (baja eficiencia), que disminuye en el P02-07 (el 19,5% vs. el 30,4%; p=0,03). Conclusiones: Se confirma la tendencia a la disminución de la estancia y la ganancia en el FIM, manteniendo la eficiencia. El grupo de baja eficiencia mejora pero, en los resultados, el percentil 75 del FIM al alta tiene valores más bajos (AU)

Introduction: The analysis of the efficiency of a stroke rehabilitation program has special importance. It requires prolonged treatments and the results depend on the kind of injury and the type and intensity of the rehabilitation treatment. Objective Analyze the results and the efficiency of the cerebral vascular rehabilitation program in patients during these periods 2002–2007 (P02-07) and 1994–2001 (P94-01). Patients and method Is a study with a group of patients who suffered a cerebral vascular accident between the 01-01-2002 and the 31-12-2007 and they had admitted in the Physical Medicine and Rehabilitation service for a treatment. We used the Functional Independence Measure (FIM) before and after the rehabilitation program. The efficiency was considered like the quotient between gain and stay. It is constructed the pattern of results and the matrix of efficiency of Stineman. We compared the efficiency, the pattern of results and the matrix of efficiency of this period (2002–2007) with the one from 1994 to 2001. Results: The patients of the P02-07 (129 patients) have a smaller age than those of the P94-01 (247 patients) (63,5 versus 69.1; IC95% 3,2 to 8,1), they have a similar FIM (76,9 and 76.8), but the gain (27,3 versus 33.7; IC95% 2,1 to 10,5) and the stay (29,3 versus 36.7; IC95% 0,7 to 13) are inferiors, and the efficiency is similar (1,5 and 1.4) in both periods. There are no differences between the patterns of results, although the percentile 75 is inferior in the P02-07 (96 versus 103). The matrix of efficiency are different in the group V (low efficiency) that falls in P02-07 (19, 5% versus 30, 4%; p=0.03). Conclusions: There is a reduction in the stay and the gain in the FIM, but the efficiency is similar. The group of low efficiency improves but, in the results, percentile 75 of the FIM at discharge has lower values (AU)