Associations between ischaemic stroke subtypes and physical functioning in the first year post-stroke: a patient-reported outcome study

Ischaemic stroke etiology, as defined by the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, has been associated with differences in survival and functional outcomes when assessed using the modified Rankin Scale (mRS). This study investigated whether similar patterns are reflected in patient-reported physical functioning during the first year post-stroke. We analysed data from the Stroke Cohort Augsburg (SCHANA), a prospective study of adults with confirmed ischaemic stroke treated at a tertiary care hospital in Southern Germany between 2018 and 2022. Physical functioning was assessed at 3- and 12-month post-discharge by using the physical domain score of the Stroke Impact Scale (SIS). Associations with stroke etiology were examined using linear mixed-effects models to improve precision and account for variable follow-up availability. The final analytic sample included 1,044 patients and was characterised by predominantly mild neurological impairment at admission (median NIHSS 2.0). In adjusted linear mixed-effects models, stroke etiology was not significantly associated with patient-reported physical functioning. No etiologic subgroup differed significantly from the cardioembolic reference group (all p > 0.05). Among patients with predominantly mild ischaemic stroke, patient-reported physical functioning varied little across TOAST-defined subtypes. This may reflect limited between-group variation in stroke severity at baseline and conceptual differences between patient-reported and clinician-assessed outcome measures such as the mRS.