Does upper limb strength play a prominent role in health-related quality of life in stroke patients discharged from inpatient rehabilitation?

Figures & data

Table 1. Baseline characteristics (n=250)

Characteristics	Baseline	Follow-up*	P value
Age (years)	57 (10)
Gender, n (% male)	162 (65)
Stroke type, n (%)
Ischemic	203 (81)
Haemorrhagic	47 (19)
Site of stroke, n (%)
Right hemisphere	116 (46)
Left hemisphere	91 (36)
Brainstem	20 (8)
Cerebellum	4 (2)
Time since onset, days	102 (64)
Stroke Impact Scale^a
Strength (0–100)	51.80 (20.27)	59.61 (22.82)	<.01
Memory (0–100)	81.83 (17.48)	87.08 (15.92)	<.01
Emotion (0–100)	82.56 (13.57)	81.89 (14.51)	.49
Communication (0–100)	84.89 (18.94)	86.51 (18.01)	.04
Activities (0–100)	70.13 (15.44)	77.43 (16.57)	<.01
Mobility (0–100)	79.32 (14.11)	85.56 (12.90)	<.01
Affected hand (0–100)	45.10 (35.59)	55.68 (37.69)	<.01
Participation (0–100)	66.75 (20.84)	71.94 (19.59)	<.01
Recovery (0–100)	56.53 (16.53)	63.56 (17.34)	<.01
Physical functioning (0–100)	60.74 (16.16)	69.57 (19.36)	<.01
Total (0–100)	70.30 (11.54)	75.61 (13.78)	<.01
Fatigue Severity Scale (1–7)^b	3.98 (1.69)	4.03 (1.67)	.43
Hospital Anxiety and Depression Scale^b
Depression (0–21)	4.40 (3.23)	4.28 (4.00)	.53
Anxiety (0–21)	3.63 (3.27)	3.66 (3.55)	.64
Nottingham Extended ADL^a
Mobility (0–18)	10.90 (4.21)	13.62 (4.14)	<.01
Kitchen (0–15)	10.06 (3.80)	12.45 (3.53)	<.01
Domestic (0–15)	4.53 (3.93)	7.95 (4.08)	<.01
Leisure (0–18)	7.31 (2.87)	10.39 (3.60)	<.01
Motricity Index^a
Arm (0–100)	60.37 (26.41)	65.35 (26.27)	<.01
Leg (0–100)	68.13 (20.16)	72.92 (20.41)	<.01

Values are displayed as mean (SD) unless otherwise indicated; *Follow-up was 12 weeks after the baseline assessment, n = 242; ^aHigher mean scores reflect better function; ^bLower mean scores reflect better function.

Table 2. Univariate regression analyzes SIS and potential predictors, baseline, and follow-up.

			Univariate regression analysis
			Stroke Impact Scale
			Baseline				Follow-up
Candidate predictors	B	95% CI	Beta	p	R^2	B	95% CI	Beta	p	R^2
Demographic
Age	.136	(−.003,.276)	.122	.055*	.015	.113	(−.057,.282)	.084	.191*	.007
Sex	−2.059	(−5.064,.947)	−.085	.179*	.007	−4.943	(−8.561, −1.326)	−.171	.008*	.029
Stroke type	.512	(−3.174, 4.199)	.017	.785	.000	.068	(−4.464, 4.600)	.002	.976	.000
Side of hemiplegia^a	−2.815	(−5.738,.108)	−.122	.059*	.015	−2.344	(−5.945, 1.257)	−.084	.201	.007
Dominant side affected^b	1.183	(−1.764, 4.131)	.051	.430	.003	.241	(−3.383, 3.864)	.009	.895	.000
Clinical
MI-arm	.276	(.234,.319)	.632	.000*	.400	.365	(.317,.413)	.696	.000*	.484
MI-leg	.278	(.215,.341)	.486	.000*	.236	.364	(.292,.436)	.539	.000*	.291
HADS	−1.048	(−1.247, −.849)	−.550	.000*	.303	−1.244	(−1.476, −1.013)	−.564	.000*	.318
FSS	−1.599	(−2.433, −.766)	−.233	.000*	.054	−2.390	(−3.376, −1.404)	−.295	.000*	.087

MI-arm/leg Motricity Index arm/been; HADS Hamilton Anxiety and Depression Scale; FSS Fatigue Severity Scale; *p < 0.2

^aDummy coding: 0 = left, 1 = right.

^bDummy coding: 0 = dominant side affected, 1 = dominant side unaffected; p-values are used to determine inclusion in hierarchical regression analysis.

Table 3. Hierarchical regression analysis.

	Stroke Impact Scale, at follow-up
	B	SE B	β	p	R^2	R^2 change	F	p
Baseline
Model 1					.644		414.546	.000*
SIS total	.965	.047	.803	.000*
Model 2					.722	.078	31.983	.000*
SIS total	.745	.054	.620	.000*
MI-arm	.159	.024	.302	.000*
MI-arm (baseline-follow-up)	.290	.049	.211	.000*
Model 3					.726	.004	1.040	.376
SIS total	.699	.068	.582	.000*
MI-arm	.145	.030	.274	.000*
MI-arm (baseline-follow-up)	.283	.050	.206	.000*
MI-leg	.042	.033	.060	.206
FSS	.231	.331	.028	.484
HADS	−.131	.107	−.057	.223
Model 4					.736	.010	2.807	.040
SIS total	.675	.070	.561	.000*
MI-arm	.152	.030	.288	.000*
MI-arm (baseline – follow-up)	.276	.049	.201	.000*
MI-leg	.041	.033	.060	.209
FSS	.166	.338	.020	.624
HADS	−.128	.107	−.056	.230
Age	−.051	.049	−.038	.297
Sex	−2.615	1.042	−.090	.013*
Hemiplegia^a	−1.130	1.013	−.041	.266

MI-arm/leg Motricity Index arm/been; HADS Hamilton Anxiety and Depression Scale; FSS Fatigue Severity Scale.

^aDummy coding: 0 = left, 1 = right; *p <.05.

R² =.071; adjusted R² =.067 (small to medium effect size, according to Cohen, 1988); F(1, 240) = 18.351, p <.0005.

Figure 1. Scatterplot and linear regression fit for change-from-baseline scores between baseline and follow-up.