title: Effect of socioeconomic status on functional and motor recovery after stroke: a European multicentre study.
abstract: BACKGROUND
  Previous studies have shown an inverse gradient in socioeconomic status for disability after stroke. However, no distinction has been made between the period in the stroke rehabilitation unit (SRU) and the period after discharge. The purpose of this study was to examine the impact of education and equivalent income on motor and functional recovery for both periods.
  
  
  METHODS
  419 consecutive patients were recruited from six SRUs across Europe. The Barthel Index (BI) and Rivermead Motor Assessment (RMA) were measured on admission, at discharge and 6 months after stroke. Ordinal logistic regression models were used, adjusting for case mix. Cumulative odds ratios (OR) were calculated to measure differences in recovery between educational levels and income groups with adjustments for case mix.
  
  
  RESULTS
  Patients with a low educational level were less likely to improve on the BI (OR 0.53; 95% CI 0.32 to 0.87) and the RMA arm during inpatient stay (OR 0.54; 95% CI 0.31 to 0.94). For this period, no differences in recovery were found between income groups. After discharge, patients with a low equivalent income were less likely to improve on all three sections of the RMA: gross function (OR 0.20; 95% CI 0.06 to 0.66), leg and trunk (OR 0.22; 95% CI 0.09 to 0.55) and arm (OR 0.30; 95% CI 0.10 to 0.87). No differences were found for education.
  
  
  CONCLUSIONS
  During inpatient rehabilitation, educational level was a determinant of recovery, while after discharge, equivalent income played an important role. This study suggests that it is important to develop a better understanding of how socioeconomic factors affect the recovery of stroke patients.
authors.affiliation: Department of Health Sciences and Medical Sociology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium. kputman@vub.ac.be
authors.forename: Koen
authors.initials: K
authors.lastname: Putman
authors.forename: Liesbet
authors.initials: L
authors.lastname: De Wit
authors.forename: Miranda
authors.initials: M
authors.lastname: Schoonacker
authors.forename: Ilse
authors.initials: I
authors.lastname: Baert
authors.forename: Hilde
authors.initials: H
authors.lastname: Beyens
authors.forename: Nadine
authors.initials: N
authors.lastname: Brinkmann
authors.forename: Eddy
authors.initials: E
authors.lastname: Dejaeger
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: De Meyer
authors.forename: Willy
authors.initials: W
authors.lastname: De Weerdt
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.forename: Walter
authors.initials: W
authors.lastname: Jenni
authors.forename: Christiane
authors.initials: C
authors.lastname: Kaske
authors.forename: Mark
authors.initials: M
authors.lastname: Leys
authors.forename: Nadina
authors.initials: N
authors.lastname: Lincoln
authors.forename: Birgit
authors.initials: B
authors.lastname: Schuback
authors.forename: Wilfried
authors.initials: W
authors.lastname: Schupp
authors.forename: Bozena
authors.initials: B
authors.lastname: Smith
authors.forename: Fred
authors.initials: F
authors.lastname: Louckx
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D004522:Educational Status; D005060:Europe; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D020127:Recovery of Function; D012923:Social Class; D020521:Stroke / Q000453:epidemiology; D000071939:Stroke Rehabilitation