[Measurement of the quality of life in stroke survivors].

OBJECTIVE: The aim of this article is to describe methods of evaluation of the quality of life in relation to health after a stroke, methodological considerations and criteria for the use of scales. DEVELOPMENT: The terms affected person, disability and handicap are defined. We discuss the indices of functional evaluation used in the study of strokes: activities of daily life (ADL), instrumental activities and the generic health questionnaires used to study quality of life. Ideally, these should all be reliable, valid and sensitive to change. The profile of the consequences of the illness, the SF-36 and Nottingham health questionnaires are valid instruments for evaluation of the quality of life of people with strokes. The Barthel index is a reliable, valid index for measurement of ADL in patients with strokes. The Rankin scale is used to evaluate disability and handicap. The indicia of activity of these instruments involve a cultural bias due to their original design. The risk of falls, painful shoulders, the presence of dysphagia or of urinary incontinence are specific complications of stroke patients. Difficulty in returning to work or driving are factors affecting the quality of life after stroke.
CONCLUSION: In the follow-up survivors with strokes it is necessary to include quality of life instruments for measurement of the dimensions of health not covered by ADL indices, especially social and emotional functions and functional state.