Comprehensive measurement of long-term outcomes and costs of rehabilitation in patients with stroke

Meijeren-Pont, W. van (2023)

Doctoral Thesis

This thesis describes the wide range of long-term consequences in stroke patients who received multidisciplinary rehabilitation.
Over a third of them reported pain in the shoulder, arm, wrist or hand. About the same percentage had low patient activation scores, which is a prerequisite for effective self-management to cope with the consequences of stroke. Almost half of patients who were working before the stroke managed to maintain paid employment for two and a half years. These patients were more satisfied with their participation than patients who did not return to work. Average independence in daily activities increased during rehabilitation. The Barthel Index was found to be more sensitive to measure change than the Utrecht Scale for Evaluation of Rehabilitation. Health-related quality of life increased on average from start of rehabilitation to one year afterwards. The average social costs in the first year were €63,045 for inpatients and €24,533 for outpatients. The burden of the nearest of stroke patients was investigated, which showed that a third of them experienced a high burden.
In conclusion, the consequences of stroke can also remain present, worsen or develop in the long term and are present for the individual patient, their nearest and the healthcare system.

• Stroke
• Rehabilitation
• Outcome measurement
• Upper extremity pain
• Return to work
• Participation
• Patient activation
• Cargiver burden
• Cost analysis
• Satisfatcion with participation

• All authors: Meijeren-Pont, W. van
• Supervisor: Vliet Vlieland, T.P.M.
• Co-supervisor: Oosterveer, D.M.; Tamminga, S.J.
• Committee: Achterberg, W.P.; Brouwer, S.; Dekker, R.; Gussekloo, J.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2023-02-22
• ISBN (print): 9789464691689