title: Functional Independence: A Comparison of the Changes During Neurorehabilitation Between Patients With Nontraumatic Subarachnoid Hemorrhage and Patients With Intracerebral Hemorrhage or Acute Ischemic Stroke.
abstract: To compare the changes in functional independence measured by the FIM after specialized neurorehabilitation between patients with nontraumatic subarachnoid hemorrhage (SAH) and patients with intracerebral hemorrhage (ICH) or acute ischemic stroke (AIS).
  
  
  
  Historical cohort study comparing changes in functional independence between patients with nontraumatic SAH and those with ICH/AIS, using FIM scores from a local database and clinical information from the Danish National Patient Registry.
  
  
  
  Postacute specialized inpatient neurorehabilitation.
  
  
  
  Participants (N=660) comprised patients with a first-time nontraumatic SAH (n=212) and age-matched patients with a first-time ICH/AIS (n=448).
  
  
  
  Not applicable.
  
  
  
  Crude and adjusted comparisons of FIM (total and item by item) measured at baseline and at discharge.
  
  
  
  Patients with nontraumatic SAH were admitted with a lower functional level compared with patients with ICH/AIS (median total FIM score, 25 [interquartile range (IQR), 18-81] vs 78.5 [IQR, 47-107]), and discharged with a lower functional level (median total FIM score, 98 [IQR, 40-116] vs 110 [IQR, 82.5-119]), although they made more progress during neurorehabilitation (median change in total FIM score, 27 [IQR, 4-60] vs 17 [IQR, 7-35]). Statistically, patients with nontraumatic SAH had significantly better odds for obtaining functional independence than did patients with ICH/AIS in 6 of the 18 FIM items: eating (odds ratio [OR]=3.2; 95% confidence interval [CI], 1.7-5.8); dressing-upper body (OR=2.0; 95% CI, 1.1-3.5); transfer tub/shower (OR=2.0; 95% CI, 1.1-3.6); stair walking (OR=2.2; 95% CI, 1.3-3.7); comprehension (OR=2.3; 95% CI, 1.3-3.9); and expression (OR=3.6; 95% CI, 2.0-6.5).
  
  
  
  Patients with nontraumatic SAH made significantly more progress during neurorehabilitation, although they were discharged with a lower level of functional independence compared with patients with ICH/AIS. However, both patients with nontraumatic SAH and those with ICH/AIS improved their functional outcome significantly. Also, patients with nontraumatic SAH admitted with severe functional outcome were shown to be capable of recovering to a moderate level of functional independence.
authors.affiliation: Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark. Electronic address: henriette.holm.stabel@midt.rm.dk.
authors.forename: Henriette Holm
authors.initials: HH
authors.lastname: Stabel
authors.affiliation: Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.
authors.forename: Asger Roer
authors.initials: AR
authors.lastname: Pedersen
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Søren Paaske
authors.initials: SP
authors.lastname: Johnsen
authors.affiliation: Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.
authors.forename: Jørgen Feldbæk
authors.initials: JF
authors.lastname: Nielsen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000534:rehabilitation*; D003718:Denmark; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D000066530:Neurological Rehabilitation / Q000379:methods*; D020127:Recovery of Function; D000071939:Stroke Rehabilitation / Q000379:methods; D013345:Subarachnoid Hemorrhage / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Activities of daily living (ADL); Outcome assessment (health care); Rehabilitation; Stroke; Subarachnoid hemorrhage