Association between personal and environmental factors and the occurrence of handicap situations following a stroke.

BACKGROUND AND PURPOSE Little is known about the potential role of environmental factors in the handicap creation process following a stroke. The objective of this study was to explore the presence of a relationship between environmental factors and the occurrence of handicap following a stroke, taking into consideration age and the level of impairments and disabilities. METHODS This is a cross-sectional study where data were collected 6 months after discharge from an intensive functional rehabilitation unit. A convenience sample of 51 participants was recruited at the time of their admission to the rehabilitation unit for rehabilitation post-stroke. Perceived influence of environmental factors was measured using the Measure of the Quality of the Environment (MQE). Handicap situations were measured with the Assessment of Life Habits (LIFE-H). Impairments and disabilities comprised six domains (cognition, perception. depression, communication, sensorimotor function and comorbidity) assessed using a variety of measuring tools from which a composite score was derived. RESULTS Fifty-one participants aged 40-97 years old took part in this study. Perceived obstacles in the environment, together with age and the level of impairments and disabilities, explained 58.9% of the variation in the LIFE-H (handicap level). Taken alone, the perceived obstacles (total score) explained 6.2%. The perceived facilitators (total score) in the environment were not found to be related to the presence of handicap situations. CONCLUSION Increased level of impairments and disabilities. advanced age and perceived barriers in the physical and social environment contribute to the handicap creation process following a stroke.

[1]  R. Hébert,et al.  Upper-extremity motor co-ordination of healthy elderly people. , 1995, Age and ageing.

[2]  R. Harwood,et al.  Handicap one year after a stroke: validity of a new scale. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[3]  M. Lilja,et al.  A study of activity in the home environment among individuals with disability following a stroke. , 1995, NeuroRehabilitation.

[4]  R. Laprise,et al.  Diagnostic Performance of the Geriatric Depression Scale and the Beck Depression Inventory with Nursing Home Residents , 1998, Canadian Journal on Aging / La Revue canadienne du vieillissement.

[5]  Carl V. Granger,et al.  Discharge Outcome After Stroke Rehabilitation , 1992, Stroke.

[6]  L. Noreau,et al.  Association between characteristics of locomotion and accomplishment of life habits in children with cerebral palsy. , 1998, Physical therapy.

[7]  R. Harwood,et al.  Determinants of handicap 1 and 3 years after a stroke. , 1997, Disability and rehabilitation.

[8]  A. Fugl-Meyer,et al.  The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. , 1975, Scandinavian journal of rehabilitation medicine.

[9]  H. Ogata,et al.  Gender differences in disability and lifestyle among community-dwelling elderly stroke patients in Kitakyushu, Japan. , 1998, Archives of physical medicine and rehabilitation.

[10]  D. Wade,et al.  Stroke: the influence of age upon outcome. , 1984, Age and ageing.

[11]  Factors predicting survival, changes in activity limitations, and disability in a geriatric post-stroke population. , 1997, The Gerontologist.

[12]  G. Dejong,et al.  Independent living: from social movement to analytic paradigm. , 1979, Archives of physical medicine and rehabilitation.

[13]  The National Survey of Stroke. Introduction. , 1981, Stroke.

[14]  A. Ljunggren,et al.  Are there gender differences in functional outcome after stroke? , 1997, Clinical rehabilitation.

[15]  C. Aldwin,et al.  Age differences in stress, coping, and appraisal: findings from the Normative Aging Study. , 1996, The journals of gerontology. Series B, Psychological sciences and social sciences.

[16]  G. Whiteneck,et al.  Quantifying handicap: a new measure of long-term rehabilitation outcomes. , 1992, Archives of physical medicine and rehabilitation.

[17]  T. Glass,et al.  The quality and quantity of social support: stroke recovery as psycho-social transition. , 1992, Social science & medicine.

[18]  G St-Michel,et al.  Social consequences of long term impairments and disabilities: conceptual approach and assessment of handicap , 1998, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[19]  D. Wade,et al.  Stroke: associations with age, sex, and side of weakness. , 1986, Archives of physical medicine and rehabilitation.

[20]  L. Moneyham,et al.  Anticipatory coping in the elderly. , 1995, Journal of gerontological nursing.

[21]  E. Adler,et al.  Relationship between physical disability and functional capacity in hemiplegic patients. , 1965, Archives of physical medicine and rehabilitation.

[22]  M. Kotila,et al.  The Profile Of Recovery From Stroke And Factors Influencing Outcome , 1984, Stroke.

[23]  K. Domen,et al.  Comorbidity measures for stroke outcome research: a preliminary study. , 1997, Archives of physical medicine and rehabilitation.

[24]  L. Gauthier,et al.  Motor Free Visual Perceptual Test: Impact of Vertical Answer Cards Position on Performance of Adults with Hemispatial Visual Neglect , 1995 .

[25]  L. Gauthier,et al.  The Bells Test: A quantitative and qualitative test for visual neglect. , 1989 .

[26]  H. Chui,et al.  The Modified Mini-Mental State (3MS) examination. , 1987, The Journal of clinical psychiatry.