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Submitted on February 10, 2005
From the Physical Therapy Program (D.S.-L.), School of Allied Medical Professions, The Ohio State University, Columbus, Ohio; the School of Nursing (P.C.C.) and the Department of Rehabilitation Medicine (A.G., S.B.), Emory University, Atlanta, Ga; and the Division of Biostatistics (A.Z.), Washington University, St Louis, Mo. Current address for A.G. is Centers for Disease Control and Prevention, Atlanta, Ga. * To whom correspondence should be addressed. E-mail: DLarsen{at}amp.osu.edu.
Background and Purpose--Health-related quality of life (HRQOL) is an important index of outcome after stroke and may facilitate a broader description of stroke recovery. This study examined the relationship of individual and clinical characteristics to HRQOL in stroke survivors with mild to moderate stroke during subacute recovery. Methods--Two hundred twenty-nine participants 3 to 9 months poststroke were enrolled in a national multisite clinical trial (Extremity Constraint-Induced Therapy Evaluation). HRQOL was assessed using the Stroke Impact Scale (SIS), Version 3.0. The Wolf Motor Function Test documented functional recovery of the hemiplegic upper extremity. Multiple analysis of variance and regression models examined the influence of demographic and clinical variables across SIS domains. Results--Age, gender, education level, stroke type, concordance (paretic arm=dominant hand), upper extremity motor function (Wolf Motor Function Test), and comorbidities were associated across SIS domains. Poorer HRQOL in the physical domain was associated with age, nonwhite race, more comorbidities, and reduced upper-extremity function. Stroke survivors with more comorbidities reported poorer HRQOL in the area of memory and thinking, and those with an ischemic stroke and concordance reported poorer communication. Conclusions--Although results may not generalize to lower functioning stroke survivors, individual characteristics of persons with mild to moderate stroke may be important to consider in developing comprehensive, targeted interventions designed to maximize recovery and improve HRQOL.
Revised on April 5, 2005
Accepted on April 15, 2005
Factors Influencing Stroke Survivors Quality of Life During Sub-Acute Recovery
Deborah S. Nichols-Larsen PhD, PT*;
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