Both neurological and rheumatic diseases constitute significant causes of disability. Participation (defined as involvement in a life situation) and health-related quality of life (HrQoL) are considered important outcomes in physical and rehabilitation medicine. Documentation of participation and HrQoL in various disabling conditions would guide rehabilitation professionals while planning their treatment interventions. The aim of this study is to determine and compare the participation and HrQoL of people with neurological versus rheumatic diseases.

Ninety patients with neurological disorders (44% stroke, 23% spinal cord injury, 20% Parkinson's) and 89 patients with rheumatic diseases (49% osteoarthritis, 33% rheumatoid arthritis, 18% ankylosing spondylitis) who were in the follow-up at the department of physical medicine & rehabilitation of a university hospital were included. Participation was assessed by Impact on Participation and Autonomy Questionnaire (IPAQ), HrQoL by Nottingham Health Profile (NHP) and activities of daily living by Modified Barthel Index (MBI).

Mean age was 58.1 in neurological patients (61% male) and 61.5 in rheumatic patients (19% male). Mean disease duration was 40.3 months in neurological group while it was 170.6 in the rheumatic group.

MBI score was significantly lower in neurological group (P=0.0001) showing more dependence in activities of daily living. Comparison of IPAQ revealed that neurologic patients experienced more participation restriction than rheumatic patients regarding autonomy indoors (P<0.0001), family role (P=0.023), autonomy outdoors (P=0.001), and work and education (P=0.05) while social life was similar. Rheumatic group reported more distress in pain (P<0.0001) and sleep (P=0.009) domains of NHP, whereas neurologic group was worse in physical mobility (P=0.012). Fatigue, social isolation and emotional reactions domains did not differ.

Although neurological diseases had great impact on physical activities and participation of patients, their social and emotional aspects of health status were similar with patients having rheumatic diseases. Furthermore, rheumatic diseases led to more pain and sleep problems.