Acute stroke patients: long-term effects of rehabilitation and maintenance of gains.
The efficacy of rehabilitation programs to facilitate recovery after acute stroke remains controversial. To further evaluate this issue, the records of 139 "middle-band" stroke survivors were reviewed retrospectively at admission to, discharge from, and one-year follow-up from inpatient rehabilitation. Patients were divided into two groups (out-patient [O/P] or no O/P) based on their involvement in physical and occupational therapy services. A repeated measures ANOVA indicated that both groups made clinically and statistically significant improvements in all functional indices between stroke onset, discharge from inpatient rehabilitation, and follow-up: O/P therapy: mobility F(1,46) = 1651, p less than .0001; self-care F(1,47) = 1062, p less than .0001; total F (1,47) = 1093, p less than .0001; no O/P therapy: mobility F(91,88) = 5643, p less than .0001; self-care F(1,88) = 5722, p less than .0001; total F(1,88) = 6733, p less than .0001. Pairwise comparisons for all functional indices revealed that all statistically significant changes in function in the no O/P therapy group occurred between stroke onset and discharge: self-care (p less than .0001), mobility (p less than .0001), and total (p less than .0001). Pairwise comparisons of all indices in the O/P therapy group revealed that all differences between stroke onset and discharge functional scores were at the p less than .0001 level, and score differences between discharge from inpatient rehabilitation and follow-up were as follows: self-care (p less than .05), mobility (p less than .001), and total (p less than .005).(ABSTRACT TRUNCATED AT 250 WORDS)
Department of PM&R, University of Michigan, Ann Arbor.
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D012648:Self Care