Article

This study focused on the relationships between cognition, participation
and quality of life (QoL) among first-ever mild ischemic stroke patients 3 months
post-event. We hypothesized that significant correlations exist between
cognition, executive functions (EF), QoL and participation; and that EF and QoL
will significantly contribute to participation beyond demographics and stroke
severity at 3 and from 3 to 6 months post-stroke. METHODS: A prospective cohort
study, recruiting consecutive first-ever stroke patients from a large tertiary
hospital. The inclusion criteria were first event, mild stroke (NIHSS </= 5), and
no previous significant neurological or cognitive impairment. In addition to
assessment every 6 month at the hospital, an assessment battery was administered
at home 3 months post-stroke. RESULTS: Participants showed mild to moderate
difficulties in cognition and participation (n = 249). Low to moderate
correlations were found between cognition and EF with participation (-0.380, p <
0.05; r = 0.460, p < 0.001, respectively); and cognition with QoL (r = 0.421, p <
0.001). EF and QoL contributed significantly to participation at 3 months (R(2) =
0.961) and in addition education at 6 months (R(2) = 0.701). CONCLUSIONS:
Participants after mild ischemic stroke experienced cognitive and EF difficulties
that affect their participation and QoL. Further studies are needed of mild
stroke survivors to enhance our understanding of the variables that affect
participation. IMPLICATIONS FOR REHABILITATION: The findings of the current study
have significant implications for the participation of people after mild stroke
in the community. Health care systems in general and rehabilitation programs, in
particular, do not consider that these clients need rehabilitation as most of
them perform basic daily functions independently. Thus, although cognitive and EF
deficits are found in people following even mild stroke, but are not externally
apparent, these impairments are mostly neglected by the health care system. Mild
stroke has long-term effects in most cases and effect family members as well. The
implications of the study's results, as well as those of other studies, emphasize
the necessity of follow-up and rehabilitation efforts at home and in the
community. These efforts should focus on re-enabling the individual to
participate in previous activities as much as possible and on providing support
for family members. The strength of this study lies in the large number of
participants who were evaluated at home in their natural environments. Studies of
this kind are rarely performed in the participants' real-life settings, thus the
current study provides an important perspective on the participation of this
population in the community.

Langue : ANGLAIS