How does stroke restrict participation in long-term post-stroke survivors?

OBJECTIVE

To explore the factors determining 'restricted participation' in a selected population of long-term post-stroke survivors.

MATERIALS AND METHODS

Seventy-three consecutive post-stroke inpatients were scored for mood and restriction in participation by means of self-administered questionnaires, respectively the Hospital Anxiety and Depression Scale (HADS/A; HADS/D) and London Handicap Scale (LHS). Neurological impairment and functional disability were evaluated with the Unified Neurological Stroke Scale (UNSS) and Functional Independence Measure (FIM).

RESULTS

Physical independence and occupation were the most severely affected domains on the LHS. UNSS, FIM, HADS/A, HADS/D scores were significant determinants of restriction in participation at univariate analysis performed with each LHS domain. FIM score and emotional status finally emerged as the independent determinants of restricted participation for the LHS domains most related to body function (mobility, physical independence, occupation). Depression was the determinant factor for orientation and social integration.

CONCLUSION

Functional disability and mood disorders may independently contribute to the restricted participation of post-stroke patients. Most of the LHS domains remain stable over time.