Functional Recovery After Stroke and Its Association with Patient’s Quality of Life and Caregiver Burden

TL;DR

This study examines how stroke survivors recover over 12 months and how this affects their quality of life and the burden on caregivers.

Contribution

The study identifies distinct long-term recovery trajectories and links them to patient and caregiver outcomes.

Findings

Three recovery trajectory classes were identified among stroke survivors.

Class 3 patients had the highest quality of life and lowest caregiver burden.

Class 2 patients showed the poorest outcomes and highest caregiver burden.

Abstract

Background: The process and dynamics of post-stroke recovery can vary considerably across patient subgroups. However, few studies have explored long-term functional recovery profiles (an essential outcome indicator), particularly in relation to patients’ quality of life, and caregiver burden. This study aimed to identify distinct 12-month trajectories of functional recovery among stroke survivors, and to examine their associations with sociodemographic and clinical factors, as well as patient-reported outcomes. Methods: The study involved 225 patients with acute ischemic stroke, assessed at admission (T0), discharge (T1), and at 3 (T2) and 12 months (T3) post-discharge. Informal caregivers participated at T2 (n = 126) and T3 (n = 118). Functional status was measured using the modified Barthel Index, quality of life using the Stroke-Specific Quality of Life scale, and caregiver burden with the Caregiver Burden Scale. Latent growth mixture modelling (LGMM) was applied to identify recovery trajectories. Associations with sociodemographic and clinical variables, quality of life, and caregiver burden were analysed using ANOVA and χ2 tests. Results: Three recovery trajectory classes were identified: Class 1 (moderate upward, 20.4%), Class 2 (low-stable, 4.9%), and Class 3 (high-functioning stable, 74.7%). Class 3 patients were younger, less impaired at baseline, and more frequently diagnosed with lacunar strokes. Class 2 comprised older, more impaired individuals and had the lowest proportion of males. Class 1 represented intermediate baseline profiles with gradual functional improvement over time. Patient-reported outcomes differed significantly between classes (p < 0.001): Class 3 had the highest quality of life and lowest caregiver burden whilst Class 2 consistently reported the poorest quality of life. Conclusions: This study demonstrates significant heterogeneity in post-stroke functional recovery and its associations with clinical, sociodemographic, and patient-reported outcomes. Identifying recovery trajectories may support more personalised stroke care and rehabilitation planning.

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