title: Clinically important improvements in motor function are achievable during inpatient rehabilitation by stroke patients with severe motor disability: a prospective observational study.
abstract: BACKGROUND
  A good motor outcome after stroke is often equated with independence in functional performance. However, for patients with severe motor disability a good outcome is unlikely, but an important change may be achievable.
  
  
  OBJECTIVE
  Determine if patients admitted to inpatient rehabilitation with severe motor disability can achieve clinically important improvements in motor function.
  
  
  METHODS
  A prospective observational study of 239 patients with stroke admitted to inpatient rehabilitation in Brisbane, Australia was conducted. On admission and discharge, participants were assessed using the motor items of the Functional Independence Measure (m-FIM). The importance of change achieved on the m-FIM was evaluated according to: 1) a statistical significant outcome; 2) achievement of a MCID based on a physician-anchored rating of change; and 3) shift in disability status e.g., severe to moderate disability.
  
  
  RESULTS
  Patients with severe motor disability achieved a significant improvement in motor function (p < 0.001), which saw up to 83% achieve a MCID and 85% shift out of 'severe' to either moderate or mild motor disability on discharge from inpatient rehabilitation.
  
  
  CONCLUSIONS
  This study demonstrates that patients admitted to inpatient rehabilitation with severe motor disability can achieve clinically important improvements in motor function on discharge from inpatient rehabilitation.
authors.affiliation: Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Hayward
authors.affiliation: School of Rehabilitation Sciences, Griffith University, Gold Coast, Australia Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia.
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Kuys
authors.affiliation: Discipline of Physiotherapy, School of Public Health Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia Community Rehab Northern Queensland, Townsville Mackay Medicare Local, Townsville, Australia.
authors.forename: Ruth N
authors.initials: RN
authors.lastname: Barker
authors.affiliation: Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Brauer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000209:etiology / Q000534:rehabilitation*; D020127:Recovery of Function; D012047:Rehabilitation Centers; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: Stroke; functional recovery; inpatient rehabilitation; motor; severe