Relationship between usual physical, cognitive and social activities and functional recovery at hospital discharge after acute stroke.

OBJECTIVE To assess the relationship between lifestyle prior to the event and functional recovery at hospital discharge after acute stroke. DESIGN Cohort study. PATIENTS A sample of 191 patients with first stroke episode (87.4% ischaemic). METHODS Severity of the event at admission was measured by the Modified National Institutes of Health Stroke Scale. The Frenchay Activity Index was used to evaluate the patients' previous lifestyles. Functional recovery was assessed using the Modified Rankin scale on discharge from hospital. A Rankin score < or = 2 was the main outcome. RESULTS At discharge, 37.2% of the patients were functionally independent. A receiver operating characteristic curve analysis established a value of > or = 18 on the Frenchay Activity Index scale as the best cut-off point to predict favourable outcome (specificity 62%; 95% confidence interval (CI) 54-69% and a sensibility of 60%; 95% CI 49-69%) with an area under the curve of 0.65 (95% CI 0.57-0.71). There was a positive association between Frenchay Activity Index > or = 18 and a Rankin score < or = 2, after controlling for potential confounders (odds ratio 2.62; 95% CI 1.21-5.66; p = 0.001). CONCLUSION This result emphasizes the protective effect of mental, physical and social activity for the prevention of functional damage after an acute cerebrovascular event.