Do performance measures of strength, balance and mobility predict QoL & community reintegration after stroke?

The aim of this study was 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.

This was a longitudinal study involving seventy-five adults recruited within one month following discharge home from inpatient stroke rehabilitation. Inclusion criteria were: major unilateral hemispheric stroke, English speaking, able to communicate, discharged home. Serious comorbidities and a prior stroke affecting the opposite side were exclusion criteria.

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

Separate stepwise linear regressions were performed with the SF-36 and SIPSO as dependent variables. The total paretic lower limb torque and 6MWT predicted the SF-36 Physical Component Summary (Adjusted R2=0.30). Total paretic lower limb torque, and TUG predicted the SIPSO Physical component (Adjusted R2=0.47). Total paretic lower limb torque significantly predicted the SF-36 Mental Component Score, but the adjusted R2 was very low (0.06). Similarly, the TUG significantly predicted the SIPSO social component, but again, the adjusted R2 was low (0.09).

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.

Targeted hip and knee strengthening

A short online course by Lee Herrington covering the principles of muscle reloading and strengthening for lower limb following injury.