[Factors affecting ADL improvement and QOL in stroke patients a community-based study]

To clarify the factors affecting improvement of activities of daily living (ADL) and quality of life (QOL) in stroke patients, 141 patients and their families attending municipal rehabilitation programs in Saitama Prefecture were surveyed by means of self-rating questionnaires and interviews. Subjects had attended the rehabilitation programs for 0-16 (mean 3.2) years. The patients were divided into two groups, i.e., ADL-improved and ADL-unimproved, according to Katz scale scores before and after their rehabilitation. Results of the multiple logistic regression analysis indicated that initial ADL before attending the rehabilitation programs and a short time interval between disease onset and start of rehabilitation are major factors for the improvement of ADL. Similarly, old age, high ADL, official certification of disability, and low frequency of rehabilitation were significant factors for high QOL as measured by Philadelphia Geriatric Center morale scale (stepwise multiple regression analysis). It is suggested that municipal rehabilitation programs pay special attention not only to accessibility of low-ADL patients, but also to psychological factors of young patients with low ADL, high frequency of attendance at rehabilitation programs and no official certification of disability.