Does Residing in Environments of Different Metropolises in a Developing Country exert an Impact on Disability after Stroke?

Abstract

Purpose: The study aimed to analyse the association between the environment in two different Brazilian metropolises (Sao Paulo and Belo Horizonte) and disability after a stroke.  Method: A cross-sectional study was conducted involving individuals with chronic hemiparesis resulting from a stroke and residing in either Sao Paulo or Belo Horizonte. The environment (city of residence) was considered an independent variable and disability (modified Rankin scale) was the dependent variable. The following clinical and demographic covariates were considered: age, number of comorbidities, socio-economic class, motor impairment (Fugl-Meyer scale), emotional functioning (Geriatric Depression Scale) and walking ability (10-metre walk test). Results: A total of 114 individuals were analysed - 51 from Sao Paulo (SP) and 63 from Belo Horizonte (BH). No association was found between the environment in which the individual resides and the degree of disability (OR = 1.436; 95%CI: 0.547 - 3.770; p = 0.46). However, the following variables were predictors of post-stroke disability: motor impairment (OR = 0.216; 95% CI: 0.090 - 0.520; p Conclusion: Living in different Brazilian cities had no impact on post-stroke disability. In contrast, motor impairment and walking ability were responsible for 77.9% of the disability found in the sample. The study findings identify possible causes of disabilities after stroke; these could facilitate the most appropriate actions to be taken during rehabilitation.