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Social dysfunctioning after mild to moderate first-ever stroke at vocational age
  1. Marc Hommel (marc.hommel{at}
  1. Stroke Unit, University Hospital - Joseph Fourier and INSERM CIC 003, University Hospital Grenoble, France
    1. Sandra Trabucco-Miguel (strabucco{at}
    1. Stroke unit, University Hospital Grenoble, France
      1. Sabine Joray (sabine.joray{at}
      1. Department of Neurology, University Hospital Lausanne, Switzerland
        1. Bernadette Naegele (bnaegele{at}
        1. Stroke Unit, University Hospital - Joseph Fourier University, Grenoble and Research Center, Grenob, France
          1. Nicolas Gonnet (ngonnet{at}
          1. INSERM CIC 003, University Hospital Grenoble, France
            1. Assia Jaillard (assia.jaillard{at}
            1. Research Center, Grenoble Institute of Neuroscience Unit UMR_S Inserm UJF - CEA U 836 - GIN, France


              Background and Purpose: With improvements in stroke treatments, the number of patients with dramatic recovery is increasing. However, many of them are still complaining of difficulties in returning to work and every day activities. We aimed to assess work and social dysfunctioning in patients with minor to moderate stroke and explore its contributing factors.

              Methods: Consecutive patients old were prospectively included at a median 7 months after a first-ever stroke. Scores on the Work and Social Adjustment Scale (WSAS), a generic self-reported scale for assessing social functioning were correlated with scores on the National Institutes of Health Stroke Scale (NIHSS), activities of daily living, Hospital Anxiety and Depression scale (HAD) and MMSE, Iowa Scale of Personality Changes and return to work at 1 year.

              Results: Among the 84 included patients (mean age 43.5 years), 57 (68%; 95% CI 57–78%) complained of significant perturbation of functioning attributed to stroke. WSAS was highly significantly related to modified Rankin scale, daily living activities, Iowa Scale of Personality Changes, and return to work at 1 year. Using ordinal logistic regression, the contributors to WSAS were initial neurological severity (NIHSS at admission), HAD, and MMSE.

              Conclusions: This study showed that up to 68% of our patients complained of significant work and social dysfunction due to stroke, despite a good clinical outcome. This self-estimation was correlated to external validation criteria, stressing the high burden of stroke from the patient’s viewpoint. Moreover, when compared across diseases, social dysfunctioning after mild stroke was as important as in other major disabling diseases.

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