SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
ROUILLARD, Susan; DE WEERDT, Willy; DE WIT, Liesbet and JELSMA, Jennifer. Functioning at 6 months post stroke following discharge from inpatient rehabilitation. SAMJ, S. Afr. med. j. [online]. 2012, vol.102, n.6, pp. 545-548. ISSN 2078-5135.
OBJECTIVES: To determine activity limitations, participation restrictions, health-related quality of life and caregiver strain in community-dwelling stroke survivors discharged from an intensive inpatient rehabilitation programme at 6 months post stroke. METHODS: Fifty-one consecutive stroke patients admitted to a Western Cape rehabilitation centre were included. Community-dwelling participants (N=46) at 6 months post stroke were assessed using the Modified Rankin Scale (MRS), Barthel index (BI), Nottingham extended activities of daily living (NEADL) scale, Euroqol (EQ-5D) instrument and caregiver strain index (CSI). RESULTS: Most participants (73.9%) were independent in activities of daily living or had minimal disability (BI 75 - 100). However, according to the NEADL, many participants were not independent in housework (60.9%), food preparation (52.2%), shopping (80.4%) and public transport use (65.2%), implying the need for caregiver assistance. According to the MRS, 29% of participants were severely disabled, requiring caregiver assistance for basic needs, and 20% could not be left alone. Feelings of anxiety or depression were felt in 50% of participants and 59% reported pain or discomfort, according to the EQ-5D. High levels of caregiver strain were reported in 56% of caregivers (CSI). Follow-up after discharge was reported in few participants. CONCLUSIONS: Consideration should be given to support for stroke survivors and caregivers after discharge and whether targeted programmes can improve specific aspects of functioning, such as community mobility.