Giovanni Morone1, Stefano Paolucci2, Marco Iosa2. 1. Clinical Laboratory of Experimental Neuorehabilitation, IRCCS Fondazione Santa Lucia, Rome, Italy. Electronic address: g.morone@hsantalucia.it. 2. Clinical Laboratory of Experimental Neuorehabilitation, IRCCS Fondazione Santa Lucia, Rome, Italy.
Abstract
BACKGROUND: The aim of the study is to determine the probability of achieving independence and the related prognostic factors with regard to single activities of daily living after 3 months of rehabilitation following stroke. METHODS: This longitudinal observational study, conducted in a neurorehabilitation unit of a research and health care institute, involved 435 subjects who were affected by stroke (age, 68 ± 14 years, 230 men). Barthel index (BI) scores were recorded at admission and dismissal 3 months later. RESULTS: The highest improvement after rehabilitation was observed for bowel and bladder function and transfer and mobility, whereas the lowest improvement was seen in bathing, grooming, dressing, and stair climbing. CONCLUSIONS: Severity of stroke, presence of unilateral neglect, age, gender, and onset-to-admission interval (OAI) were significant prognostic factors for 6 of 10 activities, as assessed by BI subscores. Feeding was influenced only by neglect and OAI, whereas OAI did not affect bowel or bladder function recovery. PRACTICE: Patients and their relatives could be informed about the specific activities in which patients will be expected to be independent after rehabilitation and the specific needs that they might have on returning home. IMPLICATION: Our results might help optimize the management of the rehabilitative process.
BACKGROUND: The aim of the study is to determine the probability of achieving independence and the related prognostic factors with regard to single activities of daily living after 3 months of rehabilitation following stroke. METHODS: This longitudinal observational study, conducted in a neurorehabilitation unit of a research and health care institute, involved 435 subjects who were affected by stroke (age, 68 ± 14 years, 230 men). Barthel index (BI) scores were recorded at admission and dismissal 3 months later. RESULTS: The highest improvement after rehabilitation was observed for bowel and bladder function and transfer and mobility, whereas the lowest improvement was seen in bathing, grooming, dressing, and stair climbing. CONCLUSIONS: Severity of stroke, presence of unilateral neglect, age, gender, and onset-to-admission interval (OAI) were significant prognostic factors for 6 of 10 activities, as assessed by BI subscores. Feeding was influenced only by neglect and OAI, whereas OAI did not affect bowel or bladder function recovery. PRACTICE: Patients and their relatives could be informed about the specific activities in which patients will be expected to be independent after rehabilitation and the specific needs that they might have on returning home. IMPLICATION: Our results might help optimize the management of the rehabilitative process.
Authors: Catherine Cooper Hay; James E Graham; Monique R Pappadis; Angelle M Sander; Ickpyo Hong; Timothy A Reistetter Journal: Am J Phys Med Rehabil Date: 2020-01 Impact factor: 3.412