Where are we in terms of poststroke functional outcomes and risk factors.
BACKGROUND
Stroke is acute vascular deterioration of cerebral functions and 2nd leading cause of death. As population gets older, as well as the increasing prevalence of stroke and disability from chronic disease, the demand for rehabilitation care will continue to rise. There is need for evidence based rehabilitation approaches and rehabilitation outcomes should be proved by objective questionnairres to qualify the process.


OBJECTIVE
To present the functional outcomes of stroke rehabilitation process among functional impairment measure evaluation. Determine the contributing factors on functional gain.


METHODS
Retrospectively assessment of data of 142 posttroke patients performed. In addition to demographical and clinical properties, functional outcomes with functional impairment measurement (FIM) and motor evaluation by Brunnstrom Motricitiy Index were recorded. Risk factors for stroke were questionned also.


RESULTS
The mean of ages was 64.30 ± 11.9 years, male/female ratios were 47.2%/ 52.8%. The functional gain was 20.4% in M-FIM, 14.7% in C-FIM. Better outcomes gained by the patients who stayed longer than 15 days (ANOVA, p: 0.000) and who had hemorrhagic etiology (MannWhitney U, p: 0.048), meanwhile there was no significant difference in gender and plegic side groups on both Motor-FIM and Cognitive-FIM gains (p > 0.05, MannWhitney U). Regression models exhibited highest impact on the M-FIM gain were the admission M-FIM scores and DM (adjusted Rsquare: 0.173, p: 0.000). Admission C-FIM scores had positive correlation with discharge C-FIM scores (r: 0.917, p: 0.000). Although older age was the negative determinant of C-FIM gain (r: -0.202, p: 0.016). We obtained the risk factor distribution 71.8% for HT, 29.6% for CAD, 25.6% for smoking, 16.2% for TIA and 33.1% for DM. All had negative impact on functional outcomes but DM had significantly (regression analysis p < 0.05).


CONCLUSIONS
Improvement by rehabilitation programme determined by FIM scores. Data provided about the poststroke patients and present risk factors. Still there exists similar ratios of risk factors as studies before eventhough prevention recommendations.
Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey.
Nil Sayiner
NS
Caglar
Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey.
Turkan
T
Akin
Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey.
Ibrahim Halil
IH
Erdem
Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey.
Levent
L
Ozgonenel
Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey.
Ebru
E
Aytekin
Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey.
Sule
S
Tutun
Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey.
Nezihe
N
Akar
Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey.
Ozcan
O
Aysar
D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D020127:Recovery of Function; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D020521:Stroke / Q000209:etiology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
Stroke; functional independence measure; rehabilitation