A.J. Dallmeijer, PhD ,  H. Beckerman, PhD, Prof. G.J. Lankhorst, MD, PhD Prof. J. Dekker, PhD 

To answer the following research questions: 1) What are the determinants of functional prognosis in multiple sclerosis (MS), traumatic brain injury (TBI) and stroke? 2) What are the patient-defined and professionally defined (health care) needs 3 years after onset of stroke and TBI and five years after MS? 3) To what extent do the health care needs match the utilization of health care and health-related community services?

The methods of this follow-up study are identical in all three diagnostic groups. Potential determinants of functional prognosis include measurement of (a) patient characteristics, (b) disease characteristics, (c) neurological and cognitive impairment, (d) disability status, (e) quality of life status, (f) personality and social environment characteristics, (g) treatments and use of rehabilitation services, and (h) comorbidity. Models of prognosis with regard to disability and quality of life will be constructed by applying multiple regression analysis and repeated measures analysis. The analyses of health care needs will consist of descriptive statistics and multiple regression models.

157 patients have been included in the MS study, 304 in the stroke study, and 126 in the traumatic brain injury study. Data are analyzed and several papers are published or submitted for publication in international journals. Until December 2007 final publications will be written. Results of the clinimetric analysis showed that the Functional Independence Measure and the Physical Functioning Scale of the SF-36 can be used in all patient groups (MS, stroke, TBI, and ALS), but for comparison of physical functioning between patient groups, differences in item difficulty should en taken into account. Care should be taken when using the SF-36 subscales 'General Health' and  'Vitality' in patients with stroke, MS and ALS. Analysis of determinants of physical functioning show that comorbidity affects the level of functioning in both patients with stroke and MS, but the course of functioning is only affected by musculoskeletal comorbidity in MS patients. Comorbidity had no effect on the course of functioning in stroke patients. Further analysis in health care needs will be performed.

Period:   12.02 - 12.07

Funding:  ZonMw

Publications 2006 VUmc:
Dallmeijer AJ, Dekker J, Knol DL, Kalmijn S, Schepers VP, De Groot, V et al. Dimensional structure of the SF-36 in neurological patients. J Clin Epidemiol 2006; 59(5):541-543.

De Groot, V, Beckerman H, Uitdehaag BM, de Vet HC, Lankhorst GJ, Polman CH et al. The usefulness of evaluative outcome measures in patients with multiple sclerosis. Brain 2006; 129(Pt 10):2648-2659.