Do performance measures of strength, balance and mobility predict quality of life and community reintegration after stroke?

Publication date: Available online 6 January 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Joshua W. Cohen, Tanya D. Ivanova, Brenda Brouwer, Kimberly J. Miller, Dianne Bryant, S. Jayne Garland
ObjectiveTo investigate the extent to which physical performance measures of strength, balance and mobility taken at discharge from inpatient stroke rehabilitation can predict health-related quality of life (HRQoL) and community reintegration after 6 months.DesignLongitudinal StudySettingUniversity LaboratoryParticipantsSeventy-five adults recruited within one month following discharge home from inpatient stroke rehabilitation. Inclusion criteria were: major unilateral hemispheric stroke, English speaking, able to communicate, discharged home. Serious comorbidities and a prior stroke affecting the opposite side were exclusion criteria.InterventionsNot applicable.Main Outcome Measure(s)Short Form 36-Item Health Survey (SF-36) for HRQoL and the Subjective Index of Physical and Social Outcome (SIPSO) for community reintegration. Physical performance measures were the 6-minute walk test (6MWT), Timed up and Go (TUG), Berg Balance Scale, Community Balance and Mobility scale, and isokinetic torque and power of hip, knee and ankle on the paretic and non-paretic sides. Other prognostic variables included age, sex, stroke type and location, comorbidities, and motor Functional Independence Measure.ResultsSeparate stepwise linear regressions were performed with the SF-36 and SIPSO as dependent variables. The total paretic lower limb torque and 6MWT predicted the SF-36 Physical Component Summary (Adjusted R²=0.30). Total paretic lower limb torque, and TUG predicted the SIPSO Physical component (Adjusted R²=0.47). Total paretic lower limb torque significantly predicted the SF-36 Mental Component Score, but the adjusted R² was very low (0.06). Similarly, the TUG significantly predicted the SIPSO social component, but again, the adjusted R² was low (0.09).ConclusionsMeasures of physical performance including muscle strength and mobility at discharge can partially predict HRQoL and community reintegration 6 months later. Further research is necessary for more accurate predictions.



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