by Michelle Rizzo

Last Updated: 2008-08-04 12:16:11 -0400 (Reuters Health)

NEW YORK (Reuters Health) – An article in the July issue of Arthritis & Rheumatism suggests that rheumatoid arthritis (RA) is associated with lower functional outcome after stroke.

Dr. Tracy U. Nguyen-Oghalai, of the University of Texas Medical Branch, Galveston, and colleagues designed their study to determine whether the swelling and pain of RA and systemic lupus erythematosus (SLE) interferes with stroke rehabilitation.

The researchers reviewed data on 47,853 stroke patients admitted to inpatient rehabilitation between 1994 and 2001. Of these, 368 patients had RA and 119 had SLE. The average Functional Independence Measure (FIM) Instrument ratings at discharge were 85.8 in RA patients, compared with 87.8 for patients with neither RA nor SLE (non-RA/SLE). Each incremental decrease in the FIM score is associated with approximately 2 to 4 minutes of required personal assistance, according to the authors.

At follow-up, the average FIM ratings were 95.9 for patients with RA and 99.6 for non-RA/SLE patients. Multivariate analyses revealed an association between RA and lower FIM ratings at discharge and follow-up.

Patients with SLE were younger than patients without either RA or SLE, but despite being younger they had similar discharge dispositions and FIM scores as the older stroke patients without SLE or RA.

"Outpatient therapy for persons with rheumatoid arthritis may reduce long-term assistance," Dr. Nguyen-Oghalai said in an interview with Reuters Health. "Patients with lupus were younger, but had similar functional outcomes to patients without rheumatoid arthritis or lupus, suggesting early morbidity from stroke among patients with lupus."

"(Our next step) is to determine whether outpatient therapy after discharge from inpatient rehabilitation can facilitate more functional recovery and reduce long-term functional disability among patients with rheumatoid arthritis," the author explained. The researchers also plan to determine whether earlier or more aggressive preventive strategies can delay and/or prevent stroke morbidity in patients with SLE.

Arthritis Rheum 2008;59:984-988.

Copyright Reuters 2008.