Social activity one and three years post-stroke

Objective: To determine the long-term course of social activity after a stroke. Design: Prospective cohort study. Patients: Patients with a first-ever supratentorial stroke were selected in 4 Dutch rehabilitation centres. Methods: Social activity was measured by the Frenchay Activities Index (FAI) at 1 and 3 years post-stroke to determine social activity. Changes in FAI scores ≤ 7 points were considered real change. Results: Data from 190 patients were available for analysis. The mean FAI score was stable between 1 and 3 years post-stroke. A decline in social activity was seen in 12% of all individuals and improvement in another 12%. Inactivity at 1 year post-stroke was strongly associated with inactivity at 3 years post-stroke (odds ratio (OR) = 19.9; 95% confidence interval (CI) 9.1-43.3). Motor impairment of the leg (OR = 0.39; 95% CI 0.15-0.97) and being socially inactive at 1 year post-stroke (OR = 0.19; 95% CI 0.04-0.84) were associated with a lower risk of decline in FAI scores. Conclusion: For the majority of stroke patients, the level of social activity is stable during the chronic phase (beyond 1 year post-stroke). Only 1 in 10 patients showed improvement, and 1 in 10 declined. The level of social activity at 1 year post-stroke is indicative of the level of social activity at 3 years post-stroke. Rehabilitation professionals should focus their follow-up programmes on patients inactive at 1 year post-stroke, as this group is at risk for chronic inactivity, and should be stimulated to achieve social reintegration.