The impact of mild stroke on meaningful activity and life satisfaction.
Patients with mild stroke are assumed to achieve full recovery with little or no intervention. However, recent studies suggest that such patients may experience persistent disability and difficulty with complex activities. We prospectively assessed the impact of mild stroke (National Institutes of Health Stroke Scale [NIHSS] score </= 5) with standard assessments of function, health-related well-being, activity participation, and stroke-specific quality of life. Of 771 patients admitted over 12 months, 377 had an NIHSS score of </= 5; of these, 244 met additional inclusion criteria, and 219 were assessed 6 months after stroke onset. Despite full independence in basic activities of daily living, many patients (87%) reported residual stroke-related changes. On average, 7 (standard deviation [SD] = 6.21) stroke-related problems (SD = 6.21) were reported on the Stroke-Adapted Sickness Impact Profile (SA-SIP). Changes in work, driving, and recreational activities were reported. Motor impairment as measured by the NIHSS or the Functional Independence Measure (FIM) motor subscale did not influence scores on outcome measures. Regression analysis predicting life satisfaction (R2 = .62) was computed. Our results indicated that SA-SIP score, emotional well-being, and activity participation were significant, but age, race, sex, NIHSS score, and FIM motor and cognitive scores were not significant. In our sample, the determinants of life satisfaction after mild stroke differed from those reported after more severe stroke. Given the mild motor impairments in our sample, other, more subtle consequences of stroke, such as depression, impaired executive function or attention, or other neurologic impairments, may play more important roles in life satisfaction.
Edwards
Dorothy F
DF
Program in Occupational Therapy, Washington University, St. Louis, Missouri, USA.
Hahn
Michele
M
Baum
Carolyn
C
Dromerick
Alexander W
AW