Abstract
Because of the positive effects of new prophylactic and curative interventions, outcomes after stroke have improved. Despite this, many patients still report reduced physical, cognitive, or emotional functions, which can affect their everyday lives.
The overall aim of this thesis was to investigate changes in mobility, in terms of balance and gait as well as spatial navigation, from the acute phase to 3 and 12 months in persons 70 years or younger with first-ever minor stroke. It also aimed to explore factors from these three different time points that were associated with impairments in balance and spatial navigation, and the self-reported level of physical activity at 12 months.
At the 12 months follow-up, the study included 101 patients. A substantial number of persons 70 years or younger with first-ever minor stroke showed impairments in mobility. From the acute phase to 12 months post-stroke, improvements in gait speed, balance, and spatial navigation outcomes were observed, mainly between the acute phase and 3 months. Although many of the participants performed well at 12 months, up to one-third had a slow gait speed, one-fourth had balance impairments, and one-fifth had problems with spatial navigation performance. These mobility impairments were associated with poor balance and executive function; females reported spatial navigation problems more often than males. The level of self-reported physical activity after 12 months was associated with balance, sick leave at stroke onset, and neuropsychiatric symptoms (anxiety/depression, fatigue, and apathy).
The factors mentioned only partially explain the observed variance, which implies that there are other factors not included in this study that influence mobility impairments, spatial navigation ability, and the level of physical activity in this subgroup of persons with stroke. The use of sensitive assessment tools in clinical practice might prevent these consequences of minor stroke from going undetected.