Impairment/function and disability/activity 3 years after cerebrovascular incident or brain trauma: a rehabilitation and occupational therapy view.

A consecutive series of 195 individuals who had had a stroke or brain trauma in 1986 responded in 1989 to a questionnaire about the consequences of the incident for occupational performance. The questionnaire contained 86 questions organized to correspond to the WHO International Classification of Impairments, Disabilities and Handicaps (ICIDH). The questions were distributed over 11 areas of occupational performance: work, leisure activities/social role, life satisfaction, sensori-motor, perceptual, intellectual, emotional function, sleep, personal care, domestic/housework/gardening, and temporal adaptation. None of the individuals considered they had attained the same level of occupational performance in all 11 areas as before the incident. Eight patterns of occupational performance were identified: 35% considered that they performed personal care at the same level and had the same temporal adaptation as before the incident, and that they had minimal impairment/disability in the other areas of occupational performance; 27% thought that they had a considerable degree of disability in all areas of occupational performance except for temporal adaptation; 8% thought that they had imbalance in temporal adaptation and severe performance difficulties in all 11 areas of occupational performance; 4% were dissatisfied with their life situation, and had a changed family role, did not practise the leisure activities they wanted, and had severe sleep problems; and for 9% the levels of performance varied a great deal and depended on the particular area of performance. The consequences of stroke or brain trauma for function and activity 3 years afterwards are considerable.