Overall recovery after stroke: a patient’s perspective

Abstract

ABSTRACT Aim The aim of this study is to describe changes in patient perceived recovery during outpatient rehabilitation, identify factors related to the patient perceived overall recovery and identify patients showing improvement on both subjective and objective measures.

Methods This is a secondary analysis with patients recruited for the FITstroke study. The primary outcome of this study is the patient perceived overall recovery which was measured using the Stroke Impact Scale. Secondary outcome measures included walking ability, balance, peripheral muscle strength, depression and anxiety, quality of life and fatigue. To find factors related to patient perceived overall recovery a regression analysis was performed. Data was dichotomized using cut-off points found in literature to identify patients showing improvement on both subjective and objective measure.

Results One hundred and sixty-four (60.6%) experienced an increased perceived overall recovery during outpatient rehabilitation. Walking ability, depression and anxiety, quality of life and fatigue were found to be significantly related to the patient perceived overall recovery. A significant association was found between walking ability and the patient perceived overall recovery.

Conclusion The majority of the patients experienced an increase in patient perceived overall recovery during outpatient rehabilitation. Several factors were found to be related to the patient perceived recovery but the final model could not explain all of the variance. It is assumed that several other factors are also related to the patient perceived overall recovery which could not be identified yet.

Clinical Relevance Improvements in function during and after the rehabilitation are often identified by changes in performance on assessment instruments. However based on the results of this study, except for walking ability, it is not clear if those identified changes are also important from the patient's perspective. To facilitate a more patient-centered approach, factors found to be related could be used in rehabilitation for setting and evaluating goals.

Keywords: Patient perceived recovery, Stroke impact scale, patients perspective, subjective outcome measure, objective outcome measure