Factors Influencing Stroke Survivors’ Quality of Life During Subacute Recovery

TLDR

Health‑related quality of life is a key outcome measure after stroke and can provide a broader view of recovery. The study examined how individual and clinical characteristics relate to HRQOL in mild‑to‑moderate stroke survivors during subacute recovery. A national multisite trial enrolled 229 participants 3–9 months poststroke; HRQOL was measured with the Stroke Impact Scale v3.0, upper‑extremity function with the Wolf Motor Function Test, and demographic and clinical variables were analyzed by ANOVA and regression across SIS domains. Older age, non‑white race, more comorbidities, and reduced upper‑extremity function were linked to poorer physical HRQOL, while additional comorbidities predicted lower memory‑and‑thinking scores and ischemic stroke with concordance predicted poorer communication; these associations suggest that individual characteristics should guide targeted interventions to improve HRQOL.

Abstract

Background and Purpose— Health-related quality of life (HRQOL) is an important index of outcome after stroke and may facilitate a broader description of stroke recovery. This study examined the relationship of individual and clinical characteristics to HRQOL in stroke survivors with mild to moderate stroke during subacute recovery. Methods— Two hundred twenty-nine participants 3 to 9 months poststroke were enrolled in a national multisite clinical trial (Extremity Constraint-Induced Therapy Evaluation). HRQOL was assessed using the Stroke Impact Scale (SIS), Version 3.0. The Wolf Motor Function Test documented functional recovery of the hemiplegic upper extremity. Multiple analysis of variance and regression models examined the influence of demographic and clinical variables across SIS domains. Results— Age, gender, education level, stroke type, concordance (paretic arm=dominant hand), upper extremity motor function (Wolf Motor Function Test), and comorbidities were associated across SIS domains. Poorer HRQOL in the physical domain was associated with age, nonwhite race, more comorbidities, and reduced upper-extremity function. Stroke survivors with more comorbidities reported poorer HRQOL in the area of memory and thinking, and those with an ischemic stroke and concordance reported poorer communication. Conclusions— Although results may not generalize to lower functioning stroke survivors, individual characteristics of persons with mild to moderate stroke may be important to consider in developing comprehensive, targeted interventions designed to maximize recovery and improve HRQOL.