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Background and Purpose The purpose of this study was to predict the functional outcome at 1 year of first-time stroke patients aged younger than 75 years in relation to the severity of stroke and demographic characteristics.Methods Population registers in three districts of southeast England were established in August 1989, with notification by stroke registry field-workers, general practitioners, and rehabilitation practitioners. Assessments were made using the Barthel index for activities of daily living at the time of maximum impairment and at 3 and 12 months after the stroke.Results Of 639 registered stroke patients, 392 without previous disability survived and were assessed for disability at 3 months, of whom 34 (9%) were severely disabled and 60 (15%) moderately disabled. Initial incontinence was the best single predictor of disability with a sensitivity of 60% and a

There is a broad scope of research that has included the Godin Leisure-Time Exercise Questionnaire in persons with multiple sclerosis. Overall, 8 papers evaluated its psychometric properties, 21 evaluated patterns of physical activity, 24 evaluated correlates or determinants of physical activity, 28 evaluated outcomes or consequences of physical activity, and 15 evaluated physical activity interventions. The Godin Leisure-Time Exercise Questionnaire is a valid self-report measure of physical activity in persons with multiple sclerosis, and further is an appropriate, simple, and effective tool for describing patterns of physical activity, examining correlates and outcomes of physical activity, and provides a sensitive outcome for measuring change in physical activity after an intervention. Implications for rehabilitation There is increasing interest in physical activity and its benefits in multiple sclerosis. The study of physical activity requires appropriate and standardized measures. The Godin Leisure-Time Exercise Questionnaire is a common self-report measure of physical activity for persons with multiple sclerosis. Godin Leisure-Time Exercise Questionnaire scores are reliable measures of physical activity in persons with multiple sclerosis. The Godin Leisure-Time Exercise Questionnaire further is an appropriate, simple, and effective tool for describing patterns of physical activity, examining correlates and outcomes of physical activity participation, and is an advantageous primary outcome for measuring change in physical activity in response to an intervention.

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Study objectives-To determine differences in incidence and case fatality of stroke in district health authorities with differing standardised mortality ratios (SMR) for stroke im residents aged under 65 years in whom death from stroke is considered 'avoidable'. Design-Registration of first ever strokes in three district health authorities. Patients were assessed and followed up over one year by one of three observers. Measurements and main results-Age specific incidence rates and survival time from stroke to death. Severity was assessed in terms ofthe level of consciousness and the presence of speech, urinary, and motor impairment within the first 24 hours of the stroke.Altogether 386 strokes were registered. There was a significant difference in the incidence rate between district health authorities in those aged under 65 (p<0.01). The overall case fatality was 26% at three weeks with no significant difference between the districts. Poor survival was associated jointly with increased age and with coma, incontinence, and swallowing impairment in the first 24 hours after a stroke.Conclusions-The SMRs for stroke in those aged under 65 in these three health districts reflect the incidence ofstroke. Case fatality at three weeks does not vary between these districts and consequently would not be a sensitive indicator ofthe quality ofcare. This also suggests that differences in services between the districts did not lead to changes in prognosis. In districts with high SMRs for stroke there is a need for further study and reduction of risk factors, thereby reducing the incidence and burden of stroke locally. This study provides a framework for assessing the needs for stroke prevention and treatment in both rural and urban areas without an elaborate protocol and detailed neurological assessment. Jf Epidemiol Community Health 1993; 47: 139-143 Stroke is one of the commonest causes of physical disability and death in adults' 2 but for someone