“Existing knowledge shows that females had more difficulty in completing daily tasks such as eating, bathing, walking, and cooking than males at three months after stroke,” says the study’s lead author, Chen Chen, PhD, a postdoctoral fellow at the University of Michigan School of Public Health in Ann Arbor.
The latest research, published in the journal Neurology, expands that knowledge by “showing that the worse performance among women lasts up to 12 months after a stroke,” she says.
What the Research Found
The study authors reviewed participants’ medical records and interviewed them to track their recovery at 3, 6, and 12 months after a stroke. Patients completed neurological assessments, cognitive tests, and questionnaires about their quality of life. From these tests, they received scores on their ability to complete tasks, including walking, bathing, cooking, and doing housework.
Women had higher average scores, corresponding to greater difficulty, than men in completing activities of daily living (like housework or shopping) and instrumental activities of daily living (like eating and bathing) at 3, 6, and 12 months.
On the other hand, Dr. Chen says, “For female patients, their ability to perform simple movements, communicate with others, and complete daily tasks continued improving from 3 months to 12 months after a stroke, and they experienced a larger improvement than male patients.”
But women “persistently experience more difficulty in completing daily tasks than male patients within the year after a stroke, especially in activities such as heavy housework, shopping, and carrying heavy weights,” she adds.
The study found no differences between men and women in other areas of recovery, such as neurological outcomes, communication, and simple movement.
Why Women May Experience Worse Stroke Recovery
It’s unclear what may be causing this gender discrepancy after a stroke, Chen says, adding that further research is needed on the subject.
Many factors could be to blame, says Mill Etienne, MD, MPH, an associate professor of neurology and medicine at New York Medical College in Valhalla. Dr. Etienne was not involved with the research.
Differences in care could be another factor, says Brian Silver, MD, a neurologist at UMass Memorial Health in Worcester, Massachusetts. Dr. Silver was not involved with the research.
Women may be more likely to live alone (with fewer people advocating for their post-stroke therapy) and may have difficulty going for rehabilitation if they are not receiving their care in an acute rehab or skilled nursing facility, Etienne says.
Overall, Etienne says, “Women have a higher burden of physical limitations, a higher emotional burden, and less advocacy.”
Advice for Women Recovering From a Stroke
Because the study found that women struggled with activities like housework and shopping, strength training should be an important part of stroke recovery for women, Chen says.
Strength-training exercises can include yoga, Pilates, tai chi, or resistance-band moves, she says. Etienne recommends using light weights for chest presses, biceps curls, rows, and triceps extensions to optimize the muscles needed for activities of daily living.
Chen suggests women work with a physical therapist to create an exercise plan tailored to them.
Silver also recommends aerobic exercise like walking.
Other tips for stroke recovery:
- Socialize in support groups or community activities.
- Get help for mental health concerns like depression and mood problems, which can affect recovery
- Stimulate your mind through reading or word games.
- Treat and manage other medical conditions, such as osteoarthritis, osteoporosis, vitamin deficiencies, chronic pain, diabetes, high blood pressure, or sleep apnea.
- Don’t hesitate to ask for additional therapy, which may include physical, occupational, speech, or cognitive therapy. Etienne says therapy should be tailored to your needs
- Quit smoking.
- Use adaptive equipment like grab bars, raised seats, reachers, and jar openers, or making home modifications.
“This study creates a new understanding that stroke recovery is sex-specific, long-term, and multidimensional, not a short 90-day trajectory,” Etienne says.
