doi: 10.1161/01.STR.0000019289.15440.F2
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2002;33:1840.)
© 2002 American Heart Association, Inc.
Original Contributions |
Persisting Consequences of Stroke Measured by the Stroke Impact Scale
From the Departments of Preventive Medicine (S.-M.L., S.P.) and Medicine (S.S.) and the Center on Aging (S.-M.L., S.S., P.W.D., S.P.), University of Kansas Medical Center, Kansas City, and Department of Veteran Affairs Medical Center, Kansas City, Mo.
Correspondence to Sue-Min Lai, MBA, MS, PhD, Department of Preventive Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160-7313. E-mail slai{at}kumc.edu
Background and Purpose— The purpose of this study was to compare disability and quality of life as measured by the Stroke Impact Scale (SIS) of stroke patients deemed recovered (Barthel Index 
95) with 2 stroke-free populations of community-dwelling elderly.
Methods— Eighty-one stroke patients who participated in the Kansas City Stroke Registry and achieved a Barthel Index of 95 at 3 months after stroke and 246 stroke-free subjects enrolled in the Community Elders Study were enrolled in this study. The Community Elders Study group was further divided into 2 groups, those recruited from the Department of Veterans Affairs Health System (VA) and a those from a local health maintenance organization (HMO). Stroke patients were administered the SIS 
90 days after stroke, and the stroke-free community dwellers were administered a version of the SIS adapted for nonstroke subjects, the Health Impact Scale (HIS). A general linear model was used to examine differences in health outcomes measured by the SIS or HIS between the KCSR stroke patients and VA and HMO community-dwelling elders after controlling for medical comorbidities and demographics.
Results— Kansas City Stroke Registry participants were significantly older than the community study groups (P=0.0052). Selected medical conditions were similar among the 3 study groups. Old age and a history of diabetes mellitus were more likely to be associated with more deficits and poor quality of life. In stroke patients deemed recovered, stroke still affected hand function, activities and independent activities of daily living, participation, and overall physical function compared with the stroke-free community dwellers in the HMO health system even after adjustment for age and diabetes status. Stroke-free community dwellers in the VA health system also had worse social participation than the stroke-free community dwellers in the HMO health system.
Conclusions— Research and clinicians have consistently underestimated the impact of stroke with the Barthel Index. This has major implications for the design of therapeutic trial designs and adequate assessments of social and economic sequelae of stroke.
Key Words: disability evaluation • quality of life • stroke
This article has been cited by other articles:
 |
|
 |
|
  F. J. Carod-Artal, L. F. Coral, D. S. Trizotto, and C. M. Moreira The Stroke Impact Scale 3.0: Evaluation of Acceptability, Reliability, and Validity of the Brazilian Version Stroke, September 1, 2008; 39(9): 2477 - 2484. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Buch, C. Weber, L. G. Cohen, C. Braun, M. A. Dimyan, T. Ard, J. Mellinger, A. Caria, S. Soekadar, A. Fourkas, et al. Think to Move: a Neuromagnetic Brain-Computer Interface (BCI) System for Chronic Stroke Stroke, March 1, 2008; 39(3): 910 - 917. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Jigjid, N. Kawashima, H. Ogata, K. Nakazawa, M. Akai, F. Eto, and N. Haga Effects of Passive Leg Movement on the Oxygenation Level of Lower Limb Muscle in Chronic Stroke Patients Neurorehabil Neural Repair, February 1, 2008; 22(1): 40 - 49. [Abstract] [PDF]
|
|
|
|
|
|
M. N. McDonnell, S. L. Hillier, T. S. Miles, P. D. Thompson, and M. C. Ridding Influence of Combined Afferent Stimulation and Task-Specific Training Following Stroke: A Pilot Randomized Controlled Trial Neurorehabil Neural Repair, October 1, 2007; 21(5): 435 - 443. [Abstract] [PDF]
|
|
|
|
|
|
J. W. Gargano, M. J. Reeves, and for the Paul Coverdell National Acute Stroke Regis Sex Differences in Stroke Recovery and Stroke-Specific Quality of Life: Results From a Statewide Stroke Registry Stroke, September 1, 2007; 38(9): 2541 - 2548. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schmid, P. W. Duncan, S. Studenski, S. M. Lai, L. Richards, S. Perera, and S. S. Wu Improvements in Speed-Based Gait Classifications Are Meaningful Stroke, July 1, 2007; 38(7): 2096 - 2100. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. L Scheets, S. A Sahrmann, and B. J Norton Use of Movement System Diagnoses in the Management of Patients With Neuromuscular Conditions: A Multiple-Patient Case Report Physical Therapy, June 1, 2007; 87(6): 654 - 669. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Wolf, C. J. Winstein, J. P. Miller, E. Taub, G. Uswatte, D. Morris, C. Giuliani, K. E. Light, D. Nichols-Larsen, and for the EXCITE Investigators Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA, November 1, 2006; 296(17): 2095 - 2104. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Dentali, M. Gianni, M. A. Crowther, and W. Ageno Natural history of cerebral vein thrombosis: a systematic review Blood, August 15, 2006; 108(4): 1129 - 1134. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Nichols-Larsen, P.C. Clark, A. Zeringue, A. Greenspan, and S. Blanton Factors Influencing Stroke Survivors' Quality of Life During Subacute Recovery Stroke, July 1, 2005; 36(7): 1480 - 1484. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. H. Dobkin Rehabilitation after Stroke N. Engl. J. Med., April 21, 2005; 352(16): 1677 - 1684. [Full Text] [PDF]
|
|
|
|
|
|
J. W. Sturm, G. A. Donnan, H. M. Dewey, R. A. L. Macdonell, A. K. Gilligan, V. Srikanth, and A. G. Thrift Quality of Life After Stroke: The North East Melbourne Stroke Incidence Study (NEMESIS) Stroke, October 1, 2004; 35(10): 2340 - 2345. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Teasell Stroke Recovery and Rehabilitation Stroke, February 1, 2003; 34(2): 365 - 366. [Full Text] [PDF]
|
|
|
|
|
|
D. B. Matchar Health Policy in Stroke: Translating What We Know Into What We Do Stroke, February 1, 2003; 34(2): 370 - 371. [Full Text] [PDF]
|
|
|
|
|
|
S.-M. Lai, S. Perera, P. W. Duncan, and R. Bode Physical and Social Functioning After Stroke: Comparison of the Stroke Impact Scale and Short Form-36 Stroke, February 1, 2003; 34(2): 488 - 493. [Abstract] [Full Text] [PDF]
|
|