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Table V. Multivariable logistic regression for the association between the independent variables and a positive outcome using Stroke
Impact Scale 3.0, domain 8 (SIS), Frenchay Activities Index (FAI) and Occupational Gaps Questionnaire (OGQ), odds ratios (OR), 95%
confidence intervals (95% CI) and p-values
Positive outcome in SIS,
OR (95% CI)
p-value Positive outcome in FAI,
Positive outcome in
OR (95% CI)
p-value OGQ, OR (95% CI) p-value
Age
Sex
Women 0.98 (0.93–1.03) 1.02 (0.99–1.05) 0.898
Men
FAI pre-stroke
Stroke severity
Moderate/severe 0.80 (0.31–2.05)
1.01 (0.95–1.08) Mild
Intervention group, Rehabilitation type
Inpatient 2.70 (0.97–7.69) Home
Control group, Rehabilitation type
Inpatient 0.45 (0.11–1.84)
Independent variables
0.510
1
1
0.646
0.729
1
Home
4.17 (2–9.09)
1
0.73 (0.30–1.77)
DISCUSSION
The aim of this study was to explore the importance of
client characteristics (age, sex, stroke severity and par-
ticipation before stroke), context (inpatient or client’s
home), and approach (enhanced client-centeredness
or not) of rehabilitation on participation in everyday
life one year after stroke. The main findings were that,
among participants receiving usual rehabilitation, stro-
ke severity and rehabilitation context were associated
with a positive outcome in participation, whereas only
stroke severity was associated with a positive outcome
for participants receiving an enhanced client-centred
intervention.
Stroke severity, i.e. having had a mild stroke, was,
in this study, associated with a positive outcome,
2.42 (1.00–5.87)
0.89 (0.49–1.62)
1.03 (0.99–1.07)
0.710
0.184
1
< 0.00
0.80 (0.37–1.72)
0.564
1
0.485
1
0.087
1.00 (0.97–1.03)
1
0.619
0.725
1
0.265
medical rehabilitation) (see Table IVb). No significant
associations were found with OGQ (see Table IVc).
Table V presents the results from the multivariable
logistic regression analyses for both groups combined
for the associations between the independent variab-
les and positive outcome for the 3 outcome measures
of participation. There were significant associations
between having a mild stroke and a positive outcome
using FAI (OR 1.00 vs 0.24 for moderate/severe
stroke). Furthermore, a nearly significant association
(p-value = 0.051) was found between home rehabilita-
tion and a positive outcome using FAI for those in the
control group (OR 1.00 vs 2.42 for in-patient rehabi-
litation) (see Table V). For the participants receiving
the enhanced client-centred intervention, there were no
significant associations between rehabilitation context
and a positive outcome using the FAI, SIS or OGQ.
Neither age, sex nor participation in everyday life be-
fore stroke were associated with a positive outcome in
participation in everyday life after stroke.
www.medicaljournals.se/jrm
0.86 (0.98–1.04)
1.02 (0.97–1.05)
1
0.058
1
3.25 (0.84–12.57)
0.309
2.70 (0.91–8.01)
0.072
1
0.051
1.13 (0.51–2.49)
0.759
using FAI for all participants, and SIS domain 8 for
those in the control group . This result may reflect
natural recovery in those with mild stroke, regardless
of which rehabilitation they received. However, one
explanation for the different results, depending on the
instrument used, could be that the instruments assess
different aspects of participation. The FAI measures the
frequency of participation in daily activities, and the
results of the current study show that a mild stroke is
associated with an increased frequency of participation
regardless of intervention received. The SIS, on the
other hand, measures the perceived impact of stroke
on participation in daily activities, and the results of
this study imply that, although the actual frequency of
participation did not change, using an enhanced client-
centred approach may reduce the perceived impact of
stroke on participation in everyday life. These results
imply that stroke severity does impact the outcomes in
participation in everyday life; however, stroke severity
may be of less importance for outcome in perceived
impact of stroke on participation when receiving an
enhanced client-centred intervention. Thus, a client-
centred approach may be particularly important for
those with moderate to severe stroke. Results from
previous studies on the association between stroke
severity and participation are inconsistent. While some
studies have shown that stroke severity, i.e. that a mild
stroke could have a positive impact on participation
both early on (at 1 month) (27) and a long time (at
6 years) after stroke (5), other studies have failed to
confirm this association (2, 28).
In addition to stroke severity, context of rehabilita-
tion, i.e. receiving home rehabilitation, was associated
with a positive outcome in participation according to
the FAI for the control group. One could argue that
participants receiving home rehabilitation have usually
had a less severe stroke and therefore are more likely to