Change in positive emotion and recovery of functional status following stroke rehabilitation in older adults

Date
2010-04-26
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Abstract

Stroke is a leading cause of disability in the United States and represents a major public health challenge. Recovery of functional status following stroke is a primary focus for rehabilitation, and is an important health outcome linked to independence, life satisfaction and quality of life. Among factors associated with recovery of functional status following stroke is positive emotion. In elderly populations, positive emotion has been shown to be protective of stroke and has been associated with functional recovery following stroke. However, most studies examining the relationship between positive emotion and recovery of functional status evaluate positive emotion at a single time point, and over relatively brief follow-up periods. Some studies report positive emotion may be a dynamic process and can change over brief periods of time. Not clear is whether positive emotion continues to change over longer time periods and whether change in positive emotion can influence recovery of functional status post stroke. \r\nThe purpose of this study was to examine change in positive emotion over a 12-month follow-up period and to determine whether change in positive emotion was associated with recovery of functional status following rehabilitation for first time stroke in an elderly, ethnically diverse patient population. This secondary analysis of data was collected on 990 older adults with first time stroke admitted to one of 20 acute medical rehabilitation facilities in the United States between 2005 and 2006. Data were examined at discharge from acute medical rehabilitation, and at 3-month and 12-month follow-up. The 12-month follow-up sample was comprised of 684 non-Hispanic whites, non-Hispanic blacks, and Hispanics aged 55 or older with first time stroke. \r\nKey findings of this study included: 1) positive emotion changed over the 12-month follow-up period with the majority of change occurring between discharge and 3-month follow-up, 2) of the patients who demonstrated change in positive emotion, more demonstrated an increase in positive emotion over the 12-month follow-up as compared to no change or a decline, 3) change in positive emotion was significantly associated with recovery of functional status post stroke after controlling for important sociodemographic characteristics and clinical measures known to impact recovery after stroke, including depressive symptoms.\r\nChange in positive emotion can occur over relatively long periods of time (i.e., 12 months) and this change is associated with recovery of functional status post stroke. \r\n

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Keywords
stroke, rehabilitation, positive emotion, function, elderly
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