Mobility status after inpatient stroke rehabilitation: 1-year follow-up and prognostic factors.
OBJECTIVE
To evaluate the stability of mobility status achieved by stroke patients during hospital rehabilitation treatment over time and to identify reliable prognostic factors associated with mobility changes.


METHODS
Follow-up evaluation in consecutive first-ever stroke patients 1 year after hospital discharge. Multiple logistic regressions were used to analyze increases and decreases in Rivermead Mobility Index (RMI) scores (dependent variables) between discharge and follow-up. Independent variables were medical, demographic, and social factors.


METHODS
Rehabilitation hospital.


METHODS
A cohort of 155 patients with sequelae of first stroke, with a final sample of 141.


METHODS
Mobility status at 1-year follow-up, as measured by the RMI, and odds ratios (OR) for improvement and decline in mobility.


RESULTS
Functionally, 19.9% improved the mobility levels achieved during the inpatient rehabilitation treatment; levels of 42.6% worsened. Patients with global aphasia (OR = 5.66; 95% confidence interval [CI], 1.50-21.33), unilateral neglect (OR = 3.01; 95% CI, 1.21-7.50), and age 75 years or older (OR = 5.77; 95% CI, 1.42-23.34) had a higher probability of mobility decline than the remaining patients. Postdischarge rehabilitation treatment (PDT), received by 52.5% of the final sample, was significantly and positively associated with mobility improvement (OR = 5.86; 95% CI, 2.02-17.00). Absence of PDT was associated with a decline in mobility (OR = 3.73; 95% CI, 1.73-8.04).


CONCLUSIONS
In most cases, mobility status had not yet stabilized at hospital discharge. PDT was useful in preventing a deterioration in mobility improvement achieved during inpatient treatment and in helping increase the likelihood of further mobility improvement.
Fondazione IRCCS Santa Lucia, Rome, Italy. s.paolucci@hsantalucia.it
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Paolucci
M G
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Grasso
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Antonucci
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Bragoni
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Troisi
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D
Morelli
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Coiro
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D
De Angelis
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Rizzi
D000203:Activities of Daily Living; D000368:Aged; D001037:Aphasia / Q000209:etiology / Q000534:rehabilitation; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012047:Rehabilitation Centers; D012384:Rome; D018709:Statistics, Nonparametric; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation