BY SARAH OWENS
Avoiding daily activities after a stroke may delay recovery and hamper survivors' sense of well-being, according to a new study published online on July 21 in Neurology.
The Importance of Rehabilitation
For some people, a stroke is a devastating event that may cause significant disabilities, including difficulty with movement, speech, and cognition. Stroke survivors may feel they need to rest as much as possible to ensure a full recovery. They may avoid going outside, taking out the garbage, or doing the laundry, and ask a spouse, family member, or friend to do these activities instead.
But is all rest really the best thing for stroke survivors? To find out, researchers in the stroke program at the University of Michigan at Ann Arbor compared the wellness outcomes of stroke patients who limited their activity to patients who maintained a modified exercise program. They identified 738 stroke survivors who were participating in the National Health and Aging Trends Study, a long-running study of people over the age of 65 on Medicare.
Of the 738 survivors, the researchers defined participants who limited their activities as those who had received help from another person in any one of 11 activities of daily living: Eating, bathing, using the toilet, dressing, going outside, getting around inside the home, getting out of bed, doing laundry, shopping, making hot meals, and handling bills/banking.
Health or Habit?
To ensure accuracy, the researchers took into account whether a person didn't participate in an activity because of habit, not because of health (for instance, if someone did not do laundry because his or her spouse always did it); whether help was available in the first place; and whether a person refrained from activity because he or she was in pain or depressed.
To assess the participants' level of well-being, the researchers examined participants' answers to questions like "How often do you feel cheerful?" and "How often are you upset or bored?" They were also asked to answer yes or no to statements like "My life has meaning and purpose," "I feel confident and good about myself," and "I like my living situation very much."
Doing Daily Activities Boosts Well-Being
Participants who limited their activity had modestly worse scores on the test of well-being while those who did not limit their activity had relatively higher scores.
After a major event like a stroke, people may reset their expectations as part of a phenomenon called the "response shift." They may believe they can't do simple tasks they did before the stroke.
Health care teams should be aware of this shift, the researchers say, and make an effort to counsel patients and their families on the importance of not limiting activity after a stroke. And patients should make an effort to engage in their usual activities to ensure their well-being.
For more on recent advances made in stroke rehabilitation, read our story, "Stronger After Stroke": bit.ly/NN-StrongerAfterStroke.