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Do Performance Measures of Strength, Balance, and Mobility Predict Quality of Life and Community Reintegration After Stroke?

Published:January 06, 2018DOI:https://doi.org/10.1016/j.apmr.2017.12.007

      Highlights

      • Paretic lower limb strength and mobility are predictors of physical health-related quality of life.
      • Faster mobility, lower age, and comorbidities predicted better social integration.
      • Poor recovery of strength and mobility affects community reintegration poststroke.

      Abstract

      Objective

      To 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.

      Design

      Longitudinal study.

      Setting

      University laboratory.

      Participants

      Adults (N=75) recruited within 1 month of discharge home from inpatient stroke rehabilitation.

      Interventions

      Not applicable.

      Main Outcome Measures

      36-Item Short Form Health Survey (SF-36) for HRQoL and Subjective Index of Physical and Social Outcome (SIPSO) for community reintegration. Physical performance measures were the 6-minute walk test, timed Up and Go (TUG) test, Berg Balance Scale, Community Balance and Mobility Scale, and isokinetic torque and power of hip, knee, and ankle on the paretic and nonparetic sides. Other prognostic variables included age, sex, stroke type and location, comorbidities, and motor FIM score.

      Results

      Separate stepwise linear regressions were performed using the SF-36 and SIPSO as dependent variables. The total paretic lower limb torque and 6-minute walk test predicted the SF-36 Physical Component Summary (adjusted R2=.30). The total paretic lower limb torque and TUG test predicted the SIPSO physical component (adjusted R2=.47). The total paretic lower limb torque significantly predicted the SF-36 Mental Component Summary, but the adjusted R2 was low (.06). Similarly, the TUG test significantly predicted the SIPSO social component, but again the adjusted R2 was low (.09).

      Conclusions

      Measures 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.

      Keywords

      List of abbreviations:

      6MWT (6-minute walk test), BBS (Berg Balance Scale), CB&M (Community Balance and Mobility Scale), HRQoL (Health-related quality of life), MCS (Mental Component Summary), PCS (Physical Component Summary), SF-36 (36-Item Short Form Health Survey), SIPSO (Subjective Index of Physical and Social Outcome), TUG (Timed Up and Go)
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