Abstract TP181: Community Based Outpatient Stroke Rehabilitation Program Achieve Excellent Outcomes Including Return to Work, Driving, Stroke Education Knowledge, and Other Rehabilitation Outcomes

Abstract

Background: Return to driving and employment are goals for many stroke survivors. There are few reports of patient centered outcomes including return to employment, driving, self efficacy, functional outcomes, stroke knowledge or characteristics of patients who achieve these goals. Methods: Prospective observational study of stroke patients treated in an interdisciplinary outpatient rehabilitation program addressing physical, cognitive, communicative, risk factors/stroke knowledge, self efficacy, psychosocial, driving and vocational issues. Results: 168 consecutive patients(104 men, 64 women, average age 62(18-90),61 aphasic)with baseline modified Rankin Scores of 5( 1%); 4(27%); 3(55%); 2(13%); 1(4%), and average NIHSS score of 6(range 0-16) were treated between 12/2011-7/2018. 116 patients suffered ischemic strokes(53 Left, 63 right, 24 bilateral hemisphere, 28 brainstem) and 52 had hemorrhages. 41% of patients had MCA territory strokes. Of 91 patients working pre-stroke, (47%) returned to work and and an additional 6% were work capable upon completion of program. 96% of patients driving pre-stroke could not drive at time of admission. After training, 45%(65/143) returned to driving. Patients had improvement in all 9 domains of Stroke Impact Scale with SIS total score improving an average of 26%. Patients received an average of 33 physical therapy visits with average percent improvement of 70% and 76% on 6 " walk and Berg Balance scores. Average Stroke Self Efficacy Scores improved from 74% to 82%. After individualized cardiovascular/stroke, and medication education sessions with the Nurse Practitioner based on AHA guidelines and Life's Simple 7's curriculum, Stroke Knowledge Quiz and risk factor knowledge scores improved 13% and 18%. Average length of stay was 5(range .5-20) months. Multiple other demographic and outcome measures are collected. Conclusions: Outcome data show a community-based team rehabilitation program can successfully combine cardiovascular education and rehabilitation services to maximize patient centered outcomes including return to work, driving, overall stroke recovery, physical functioning, stroke knowledge, and self efficacy for many types of stroke survivors with moderate to severe disability.