title: Functional gain following rehabilitation of recurrent ischemic stroke in the elderly: experience of a post-acute care rehabilitation setting.
abstract: The aim of the study was to evaluate whether rehabilitation of patients with recurrent ischemic strokes is associated with functional gain. We studied a total of 919 consecutive post-acute ischemic stroke elderly patients admitted for rehabilitation. 22% out of the patients had recurrent stroke on index day. Functional outcomes of first-ever stroke patients and recurrent ischemic stroke patients were assessed by the Functional Independence Measurement scale (FIM™) at admission and discharge. Data was analyzed by t-test, Chi-square test and by multiple linear regression analysis. There were 716 patients with first ever stroke and 203 patients with recurrent stroke. Total and motor FIM scores at admission and total, motor, gain and Montebello Rehabilitation Factor (RFG) FIM scores at discharge were similar in the two groups. A multiple linear regression analysis showed that age (beta=-0.13, p=0.001) length of stay (beta=0.21, p<0.001), Mini-Mental State Examination score (MMSE) (beta=0.1, p=0.01), and admission total FIM (beta=-0.12, p=0.01) emerged as the only independent predictors of higher gain FIM scores at discharge. The finding suggests that elderly patients with recurrent ischemic stroke admitted to rehabilitation ward, showed similar FIM gain scores at discharge, compared with first-ever stroke patients. It is concluded that recurrent stroke should not be considered as adversely affecting the short-term functional outcomes of patients in a post-acute rehabilitation setting.
authors.affiliation: Department of Geriatric Medicine and Rehabilitation, Shmuel-Harofe Hospital, Beer-Yaakov 70300, Israel; The Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel. Electronic address: eli.mizrahi@grsh.health.gov.il.
authors.forename: E H
authors.initials: EH
authors.lastname: Mizrahi
authors.affiliation: Department of Geriatric Rehabilitation, Sheba Medical Center, Tel-Hashomer 52621, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Fleissig
authors.affiliation: Department of Geriatric Rehabilitation, Sheba Medical Center, Tel-Hashomer 52621, Israel; The Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Arad
authors.affiliation: Department of Geriatric Rehabilitation, Sheba Medical Center, Tel-Hashomer 52621, Israel; The Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Adunsky
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation*; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D015999:Multivariate Analysis; D010351:Patient Discharge / Q000706:statistics & numerical data; D020127:Recovery of Function; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: Functional outcome; Recurrent ischemic stroke; Stroke rehabilitation