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European Journal of Physical and Rehabilitation Medicine 2010 September;46(3):389-99

Copyright © 2010 EDIZIONI MINERVA MEDICA

lingua: Inglese

Is health-related-quality of life of stroke patients influenced by neurological impairments at one year after stroke?

Franceschini M. 1, La Porta F. 2, Agosti M. 3, Massucci M. 4

1 Department of Rehabilitation IRCCS San Raffaele, Pisana, Rome, Italy; 2 Rehabilitation Medicine Unit, Civil Hospital, Modena, Italy; 3 Geriatrics and Rehabilitation Department, Parma University Hospital, Parma, Italy; 4 Rehabilitation Unit, Hospital of Passignano sul Trasimeno Perugia, Italy


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AIM: The aim of this study was to evaluate which neurological impairments on discharge from rehabilitation services are associated with a worse outcome in terms of health related-quality of life (HRQoL) one year after stroke.
METHODS: We enrolled 528 first-time stroke patients in a multicenter observational study involving 18 Italian inpatients rehabilitation centers. Neurological impairment-related factors, socio-demographic and general clinical variables and process indicators were considered independent variables at discharge. Outcome was represented by the following dependent variables of HRQoL: EuroQoL-5D questionnaire (5D-EQoL) and its derived index (Eq-Index) and a Visual Analogue Score (QoL-VAS).
RESULTS: The strongest predictors of lower HRQoL were an incomplete limbs motor recovery. An incomplete lower limb motor recovery was associated with a lower HRQoL only in the “mobility” domains, whereas a incomplete upper limb motor recovery could predict a lower HRQoL in all domains except “mobility”. Regarding cognitive impairments, the presence of neglect at discharge was associated with a lower HRQoL in “self-care”, “pain-discomfort” and “anxiety-depression”. Female gender, presence of urinary catheter seemed to exert a much lesser role in predicting HRQoL.
CONCLUSION: The results of this study suggest that upper limb motor impairments may have a detrimental impact on the patient’s perceived HRQoL one year after stroke.

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