Handicap in stroke survivors

Background and purpose: As survival following stroke improves, individuals are more likely to live with the aftermath of stroke rather than immediatel y die from it. The purpose of this study was to examine the consequences of stroke on the life activities of survivors in the social realm (stroke han dicap) using the framework of the World Health Organization's International Classification of Impairments, Disabilities and Handicaps. Methods: Multivariate analysis of variance was applied to cross-sectional d ata from a clinical study to investigate the correlates of handicap in a co hort of hemispheric stroke survivors at 3 months (n = 145) and at 1 year (n = 135) after stroke onset. Handicap was assessed with the Reintegration to Normal Living Index, impairment by the Adams' Hemispheric Stroke Scale and Zung Depression Scale, and disability by the Functional Independence Measu re. Environmental variables in the model included marital status and receip t of rehabilitation therapy. Results: Physical disability and post-stroke depressive symptoms were assoc iated with handicap at both follow-up periods (p < 0.05). Cognitive disabil ity and impairments from a previous stroke were also associated with handic ap (p < 0.01), but only at 1 year. The presence of a spouse was found to be nefit male survivors at 1 year. Conclusions: Disability and depressive symptoms restrict the meaningful lif e activities of stroke survivors in the first year of recovery. Social supp orts may be influential in reducing their impact.