Original Research - Special Collection: Disability Unplugged

Post stroke health-related quality of life, stroke severity and function: A longitudinal cohort study

Tasneem Hartley, Marlette Burger, Gakeemah Inglis-Jasiem
African Journal of Disability | Vol 11 | a947 | DOI: https://doi.org/10.4102/ajod.v11i0.947 | © 2022 Tasneem Hartley, Marlette Burger, Gakeemah Inglis-Jassiem | This work is licensed under CC Attribution 4.0
Submitted: 09 September 2021 | Published: 26 January 2022

About the author(s)

Tasneem Hartley, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Department of Physical Therapy and Rehabilitation Science, College of Health Sciences, Qatar University, Doha, Qatar
Marlette Burger, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Gakeemah Inglis-Jasiem, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

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Background: Health related quality of life (HRQoL) is a determinant of physical, social and emotional well-being post-stroke.

Objectives: This study aimed to correlate self-reported HRQoL with activities of daily living (ADL) and stroke severity.

Method: A longitudinal observational study was conducted at a rehabilitation centre in the Western Cape, South Africa. Stroke inpatients were sampled over 6 months. The Euro-QoL Five Dimensions instrument (EQ5D-3L) for self-reported HRQoL, Barthel Index (BI) for function and independence in ADL, and modified Rankin Scale (mRS) for stroke severity were administered on admission and discharge. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25.

Results: Of the 54 potential participants, 49 met inclusion criteria and 41 completed reassessments (median age 48 years [interquartile range {IQR} 39–60]; median length of stay 53 days [IQR 46–60]). Most participants had infarctions (89.90%); with hypertension or diabetes risk factors (73.47% and 28.57%, respectively). The BI and mRS scores improved significantly (p < 0.001) with very strong correlation between scores (rs = -0.874, p < 0.001); indicating a trend of decreased stroke severity as function improved. The EQ5D Visual Analog Scale (VAS) scores (p < 0.001) and domains mobility, self-care, usual activities (p < 0.001) and pain/discomfort (p = 0.034) improved significantly. The anxiety/depression domain showed a non-significant change (p = 0.378). A weak negative significant correlation existed between EQ5D VAS and mRS scores (rs = -0.362; p = 0.02); indicating a trend that HRQoL was not improving to the degree stroke severity decreased. A weak positive significant correlation was seen between EQ5D VAS and BI scores (rs = 0.329; p = 0.036).

Conclusion: Although an improvement was noted in HRQoL, EQ5D VAS scores tended not to improve as strongly, despite significant improvements in function and stroke severity. These findings demonstrate the need for psychological support and pain management interventions for adjustment post-stroke.


stroke; cerebrovascular accident; health-related quality of life; function; South Africa


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Crossref Citations

1. Mediating effect of post-stroke depression between activities of daily living and health-related quality of life: meta-analytic structural equation modeling
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doi: 10.1007/s11136-022-03225-9