Abstract
Introduction: Knowledge about residual deficiencies and their consequences on daily life activities among stroke patients living at home 1-year after the initial event managed in stroke units is poor. This multi-dimensional study assessed the types of deficiencies, their frequency and the consequences that the specific stroke had upon the daily life of patients.Methods: A cross-sectional survey, assessing, using standardized scales, 1 year post-stroke disabilities, limitations of activities, participation and quality of life, was carried out by telephone interview and by mail in a sample of stroke patients who returned home after having been initially managed in a stroke unit.Results: A total of 161 patients were included (142 able to answer the interview on their own; 19 needing a care-giver). Amongst a sub-group of the patients interviewed, 55.4% (95% Confidence Interval [47.1–63.7]) complained about pain and 60.0% (95% CI [51.4–68.6]) complained of fatigue; about 25% presented neuropsychological or neuropsychiatric disability. Whilst 87.3% (95% CI [81.7–92.9]) were independent for daily life activities, participation in every domains and quality of life scores, mainly in daily activity, pain, and anxiety subscales, were low.Conclusion: Despite a good 1-year post-stroke functional outcome, non-motor disabling symptoms are frequent amongst patients returned home and able to be interviewed, contributing to a low level of participation and a poor quality of life. Rehabilitation strategies focused on participation should be developed to break the vicious circle of social isolation and improve quality of life.
Highlights
Knowledge about residual deficiencies and their consequences on daily life activities among stroke patients living at home 1-year after the initial event managed in stroke units is poor
A cross-sectional survey of 1-year post-stroke deficiencies, limitations in activities, participation and quality of life was conducted in a population of patients, included in the Aquitaine Observatory of Stroke (ObA2), from October 1st to December 4th 2013 with a stroke managed in one of the stroke units participating to ObA2
The study sample included patients of the study population alive at 1-year after a stroke managed in a stroke unit, living at home at 1 year post-stroke, with an available phone number at ObA2 admission and willing to participate
Summary
Knowledge about residual deficiencies and their consequences on daily life activities among stroke patients living at home 1-year after the initial event managed in stroke units is poor. While motor impairment, spasticity or aphasia are recognized complications, other deficiencies, such as cognitive impairment [2], depression [3], or fatigue [4] are frequently reported but under-evaluated and poorly managed amongst stroke survivors These so-called “invisible” deficiencies are thought to contribute to reduced ability to participate in daily life activities and impaired quality of life [5]. While most of patients able to return at home following stroke managed in stroke units are supposed to have a good outcome, they may suffer from a lack of monitoring Residual deficiencies and their consequences upon the daily life activities have mainly been assessed in large and representative populations of stroke patients [6]. Little information is available about post-stroke sequelae in the population of patients living at home and having been managed in stroke units
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