Stroke onset and rehabilitation: time lag as a factor in treatment outcome.

Increasing time between stroke onset and initiation of rehabilitation has been associated with poorer outcome in published reports. However, this conclusion is difficult to generalize because of variations in study sample size and selection. The present study examines rehabilitation outcomes for 687 patients admitted to a private rehabilitation center. Outcome variables include measures of ambulation, transfers, upper extremity function, and self-care in dressing, feeding, hygiene, communication, and household and homemaking activities. The association of outcome with fourteen variables, including time since onset, is explored using a multiple regression approach. Results suggest that time since stroke onset before admission to a rehabilitation facility has a minor effect on outcome when adjustments for other variables are taken into account. Its effects appear to be limited to treatment received in physical therapy, such as transfers and ambulation training. Other variables such as patient age, judgment, attention to task, and skill carryover are consistently associated with outcome measures and should be considered when assessing rehabilitation potential.