The stroke patient in an urban environment

Abstract

A cohort of 70 patients who had had a stroke a median of 19 months, for males, and 23 months, for females, beforehand and had been treated intensively in a rehabilitation unit, was compared with an age matched control group (25) of normal people living in the same city.

Two thirds of patients were moderately or severely limited in their independence on the Barthel Scale; only4% had a normal level of social activities (Frenchay Index) and half were depressed (Wakefield Scale). Mobility was severely impaired, only 15% being able to walk more than 440 yards. Only one subject drove a car, few could use public transport, and only two people returned to work full time. Use of health services and social services was low. No control subjects had any such problems. Therefore, the social effects of stroke are severe; they persist for many years and they are not addressed by current inpatient treatment. New models of treatment must be devised and evaluated to reduce social isolation and depression in the patient and carer.