Estimating Utility Values for Health States of Nigerian Individuals with Stroke or Epilepsy Using the SF-36: A Brief Report on the Results of a Cross-Sectional Survey.

Background. Stroke and epilepsy are the most common neurologic conditions affecting individuals. The Short Form Six-Dimension Health Index (SF-6D) is a preference-based measure of health developed to estimate utility values from the SF-36. This study estimated utility values for health states of Nigerian individuals with stroke or epilepsy using the SF-36. Methods. SF-36 responses from 125 and 69 individuals with stroke and persons with epilepsy, respectively, were transformed into health state utility values using the SF-6D algorithm. The Excel program developed by Brazier and colleagues was used to generate the SF-6D utility score estimated using a set of parametric preference weights. The health state utility values were determined using ordinal health state and standard gamble valuation techniques. Results. Mean (s) ages of the stroke and epilepsy participants were 63.1 (11) and 39.6 (16) y, respectively. The mean (s) utility scores for stroke and epilepsy were 0.52 (0.10) and 0.65 (0.1) for standard gamble and 0.48 (0.13) and 0.68 (0.11), respectively, using the ordinal health state paradigm. The mean (s) utility of stroke (female = 0.46 [0.15]; male = 0.50 [0.12]) and epilepsy (female = 0.65 [0.13], male = 0.69 [0.11]) participants were reported. The mean (s) annual episodes of seizure was 18.7 (39). Conclusions. To our knowledge, this is the first study to suggest that females with stroke and those with epilepsy considered their health to be poorer than that of their male counterparts. The significance of our findings is that they may be helpful for researchers, policy makers, and clinicians by providing input into economic evaluations to facilitate resource allocation for stroke survivors and people living with epilepsy to improve their health outcomes and reduce the huge burden associated with the conditions. Highlight: We estimated a health state utility value for stroke and epilepsy to aid researchers and public health policy makers in conducting health economic analysis and outcomes research.

Do self-efficacy, body mass index, duration of onset and pain intensity determine performance on selected physical tasks in individuals with unilateral knee osteoarthritis?

PURPOSE: To investigate the contributions of Pain Self-Efficacy (PSE), Function Self-Efficacy (FSE), Body Mass Index (BMI), duration of onset of Knee OsteoArthritis (KOA) and Present Pain Intensity (PPI) to performance on Stair Task Test (STT), Timed Up-and-Go (TUG) and 20-Meter Walk Test (20-MWT) and explore correlations among the variables in individuals with unilateral KOA. METHODS: Participants were 51 (22 male, 29 female) consecutively-selected patients with unilateral KOA. Participants' self-efficacy (PSE, FSE), and PPI were assessed using Arthritis Self-Efficacy Scale and Box Numerical pain scale respectively. Participants' performance on STT, TUG and 20-MWT was also assessed. Data were analyzed with Pearson product moment correlation and Stepwise linear regression at alpha level of 0.05. RESULTS: Participants' mean age, duration of KOA onset and BMI were 52.18 ± 10.69 years, 30.29 ± 29.03months and 26.06 ± 3.86 kg/m2 respectively. Participants' scores on 20MWT, TUG and STT had significant direct correlations with each other and with PPI while PPI had significant indirect correlations with PSE (r = -0.59) and FSE (r = -0.56). PSE had significant direct correlation (r = 0.65) with FSE. Both PSE and FSE had significant but low inverse correlations with scores on the performance tests. PPI explained about 43% or more of the variance in 20-MWT, TUG and STT. PPI and onset of KOA explained 62% of variance in 20-MWT while PPI and BMI jointly explained 60% of variance in TUG. CONCLUSION: Though PSE and FSE significantly correlated with scores on the performance tests, PPI, duration of OA and BMI were the significant determinants of performance.

Weight bearing asymmetry and functional ambulation performance in stroke survivors.

This study evaluated asymmetry of weight bearing on the lower limbs and the association between percentage weight bearing asymmetry (PWBA) and functional ambulation performance in ambulant stroke survivors. Participants were 53 stroke survivors (male = 35, female = 18) aged 40-86 years (mean=58.87; SD=9.21years) with hemiparesis. Weight bearing through the lower limbs in standing was assessed by two juxtaposed bathroom weighing scales while functional ambulation performance was evaluated with the Emory Functional Ambulation Profile (E-FAP). Data were summarized with mean and standard deviation and further analyzed using the Pearson product moment correlation at 0.05 alpha level. Participants bore 60.3% (SD =7.1%) of their body weights on the unaffected legs and had a mean PWBA of 20.8 % (SD=14.7%). There was a significant positive correlation (r = 0.675, p < 0.0001) between PWBA and total E-FAP scores of participants. PWBA could hence be used to monitor functional ambulation recovery in stroke survivors.