Quality of life after stroke rehabilitation among urban vs. rural patients in Thailand.

BACKGROUND: Stroke patients who live in different areas might have different adjustments for their impairment and disability after stroke attack. These factors should be evaluated in Thai patients. OBJECTIVE: To compare functional outcome, psychological outcome and quality of life of stroke patients who live in urban vs. rural areas, before and after an in-patient rehabilitation program. STUDY DESIGN: A multi-center, prospective, analytical study. MATERIAL AND METHOD: Urban and rural stroke patients admitted to the rehabilitation ward received a rehabilitation program. Pre- and post-rehabilitation, patients were measured using the Barthel index, the Hospital Anxiety and Depression scale (HADS) and the WHO BREF QOL questionnaire. The data were collected from nine rehabilitation centers in Thailand. RESULTS: Significant improvement in functional outcome, psychological condition and quality of life score was achieved via the rehabilitation program in both groups. There was no statistically significant difference between urban vs. rural patients. CONCLUSION: Previous living areas (urban vs. rural) before admission had no effect on functional outcome, psychological outcome and quality of life among stroke patients after an in-patient rehabilitation program conducted in Northeast Thailand.

Age-related rehabilitation outcome in stroke patients.

BACKGROUND: Patients who survive a stroke usually have residual neurological deficits. Consequently, a rehabilitation program is valuable for improving their quality of life (QOL). However, age is a known factor that needs qualification vis-à-vis rehabilitation outcomes among Thai patients. OBJECTIVE: To study the functional and psychological outcomes and the QOL before and after rehabilitation program among three age groups of Thai stroke patients (< or = 44, 45-64 and > or = 65 years of age). STUDY DESIGN: Prospective, analytical study. MATERIAL AND METHOD: Three hundred and twenty seven stroke patients were measured using the Barthel index, the Hospital Anxiety and Depression scale (HADS) and the WHO QOL BREF questionnaire before and after undergoing an in-patient rehabilitation program. Data were collected from nine sites around Thailand. RESULTS: Functional and psychological outcomes and the quality of life score improved after the rehabilitation program. The youngest group of stroke victims showed the greatest improvement in functional outcome and QOL score in both the physical and social domains. No significant difference was found regarding anxiety and depression among the three groups. CONCLUSION: An in-patient rehabilitation program was of benefit to Thai stroke patients but age significantly determined rehabilitation outcomes.