Evaluation of a long-term community based rehabilitation program for adult stroke survivors

Objectives: To evaluate the functional status, leisure activity and satisfaction in adult stroke survivors participating in a community rehabilitation program, and to compare these outcomes with stroke survivors not attending any program. Method: Subjects included in the study were survivors of a first stroke that received inpatient rehabilitation and were living at home at least one year post onset. Twenty seven were participants in a community rehabilitation program and 56 were non-participants. The outcome measures were the Stroke impact Scale (SIS), Functional Independence Measure (FIM), Instrumental Activities of Daily Living Questionnaire (IADLq), Activity Card Sort (ACS), and the Life-Satisfaction questionnaire (Li-Sat-9). Results: The results revealed severe stroke impact and low functioning in activities of daily living in the participant group, yet the level of participation in leisure activities improved significantly after attending the program (t=-8.1, p=0.000). The comparison with the non participant group revealed that participants were even more disabled in basic activities of daily living (as measured by the FIM) than non-participants (t=-3.1, p=0.004). However, the satisfaction rates of the participants were significantly higher than non participants from "life as a whole" and from their leisure situation (p<0.05). Conclusions: Stroke survivors participating in a community based rehabilitation program did not show an advantage in terms of disability levels over non-participants. However, their activity level increased due to the program and their satisfaction scores were higher than non-participants.