Functional independence measured in the acute phase of stroke predicts both generic and specific health-related quality of life: a 3-month prospective study in a middle-income country

Abstract

Purpose

To identify acute predictors of both generic and specific health-related quality of life (HRQoL) 3 months after stroke in individuals from a middle-income country.

Materials and methods

A 3-month prospective study with individuals who had suffered their first stroke, without previous disability, discharged from a stroke unit. The dependent outcomes, assessed 3 months after stroke, were generic and specific HRQoL (SF-36 and SSQOL total scores, respectively). The predictors assessed in the stroke unit were age, sex, education level, duration of hospital stay, current living arrangement, stroke severity (National Institutes of Health Stroke Scale-NIHSS), functional independence (Modified Barthel Index-MBI), motor impairment (Fugl-Meyer Assessment), and lower- and upper-limb residual muscle strength deficits. Linear multiple regression analyses were employed to identify predictors of both generic (model-1) and specific (model-2) HRQoL (α = 5%).

Results

One hundred twenty-six individuals were assessed at 3-month post-stroke (61.3 ± 13.6 years). Regression analysis showed that functional independence was the best predictor of both generic (R² = 21%; F = 34.82; p < 0.001) and specific (R² = 29%; F = 51.71; p < 0.001) HRQoL at 3-month post-stroke.

Conclusion

Both generic and specific HRQoL at 3-month post-stroke can be predicted by functional independence assessed in the acute phase with the MBI.

IMPLICATIONS FOR REHABILITATION

• Health-related quality of life (HRQoL), a patient-centered outcome, is essential for healthcare, mainly in stroke, a chronic disease with a broad spectrum of disabilities.

• Functional independence is a key outcome and should always be a part of characterizing patients before the rehabilitation process.

• Functional independence assessed with the Modified Barthel Index in the acute phase of stroke predicts both generic and specific HRQoL at 3-month post-stroke.

• Patients post-stroke with lower functional independence at hospital discharge may be at risk of having lower HRQoL at 3-month post-stroke.

Keywords:

• Stroke
• health-related quality of life (HRQoL)
• functional independence
• rehabilitation
• prospective study

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

CAPES (Finance Code 001); CNPQ (308516/2021-4); Fundação de Amparo a Pesquisa do Estado de Minas Gerais (PPM-00496-17 and APQ-00736-20); Pró-Reitoria de Pesquisa, Universidade Federal de Minas Gerais; and, Pró-Reitoria de Extensão, Universidade Federal de Minas Gerais.