Predictive factors of functional gain in long-term stroke survivors admitted to a rehabilitation programme.
OBJECTIVE
To assess factors that may influence functional gain of patients with chronic sequelae of stroke.


METHODS
Prospective study of 290 stroke patients consecutively admitted to a rehabilitation setting.


METHODS
Functional Independence Measure Scale (FIM) was used to assess functional capacity. Functional improvement registered during hospitalization (FIM-gain score) was compared to demographic data, stroke sub-type, vascular risk factors, motor deficit, visual hemineglect, aphasia, level of response and sphincter control. FIM-gain score was classified as high-gain (=22) and low-gain (<22).


RESULTS
Two hundred and fifty-two patients who had no prior rehabilitation and were capable of completing the rehabilitation programme were studied (average age 58.4+/-13.9 years; 42.9% women). The mean time from stroke onset to admission was 271.5 days. Average FIM score at admission was 58.8 and at discharge was 81.6. Average FIM Gain was 23.6. The 38% patients admitted later than 6 months after stroke had an average FIM Gain of 19 vs 26 for patients admitted prior to 6 months. Significant predictors of functional improvement were time from stroke onset, age, sitting balance and level of responsiveness.


CONCLUSIONS
The functional improvement scores in persons with stroke beginning a rehabilitation programme at a later stage are 73% of the scores obtained by patients beginning treatment in the first 6 months. FIM score improvement can be predicted by time since stroke onset, age, sitting balance and level of responsiveness.
Carod-Artal
F J
FJ
The SARAH Network of Rehabilitation Hospitals, Neurology Department, Sarah Hospital, Brasilia DF, Brazil. javier@bsb.sarah.br
Medeiros
M S M
MS
Horan
T A
TA
Braga
L W
LW
D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010468:Perceptual Disorders / Q000150:complications; D004856:Postural Balance; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors