title: Predictors of physical independence at discharge after stroke rehabilitation in a Dutch population.
abstract: The aim of this study was to identify predictors, available at admission, of physical independence at discharge from inpatient rehabilitation. Secondary aims were to identify predictors of functional gain and length of stay (LOS). We included 1310 adult stroke patients who were admitted for inpatient rehabilitation in five Dutch rehabilitation centres. Data on the Utrecht Scale for Evaluation of Clinical Rehabilitation at admission and discharge (physical and cognitive independence, mood, pain and fatigue), age, sex and in a subsample stroke characteristics as well were collected. A prediction model was created using random coefficient analysis. None of the stroke characteristics were independently associated with physical independence or functional gain at discharge, or LOS. Higher physical and cognitive independence scores and severe pain at admission were predictors of higher physical independence scores at discharge. Furthermore, lower physical independence scores, higher cognitive independence scores, less pain at admission and younger age predicted more functional gain. Finally, lower physical and cognitive independence scores at admission and younger age predicted longer LOS. Physical independence at admission was the most robust predictor for rehabilitation outcome in a Dutch rehabilitation setting. To a lesser extent, age, cognitive independence and pain predicted rehabilitation outcome after stroke. Treatment of cognition and pain should be taken into account during rehabilitation. Further work needs to be carried out to establish whether focusing on these factors improves outcome after rehabilitation.
authors.affiliation: aCenter of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht bDepartment of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee cCoronel Institute for Occupational and Environmental Health, Academic Medical Center, University of Amsterdam, Amsterdam dUniversity of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen eRoessingh Rehabilitation Center, Enschede fRevant Rehabilitation Center Breda, Breda gRijndam Rehabilitation Centre, Rotterdam, The Netherlands.
authors.forename: Antonia F
authors.initials: AF
authors.lastname: Ten Brink
authors.forename: Tibor R S
authors.initials: TR
authors.lastname: Hajos
authors.forename: Coen
authors.initials: C
authors.lastname: van Bennekom
authors.forename: Janneke
authors.initials: J
authors.lastname: Nachtegaal
authors.forename: Henk E J
authors.initials: HE
authors.lastname: Meulenbelt
authors.forename: Judith F M
authors.initials: JF
authors.lastname: Fleuren
authors.forename: Mirjam
authors.initials: M
authors.lastname: Kouwenhoven
authors.forename: Marscha M
authors.initials: MM
authors.lastname: Luijkx
authors.forename: Markus P
authors.initials: MP
authors.lastname: Wijffels
authors.forename: Marcel W M
authors.initials: MW
authors.lastname: Post
mesh_terms: D000367:Age Factors; D004185:Disability Evaluation; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010351:Patient Discharge; D012044:Regression Analysis; D000071939:Stroke Rehabilitation