Abstract WP188: Community-Based Outpatient Stroke Rehabilitation Program Achieves Excellent Outcomes Including Return to Work, Driving, Stroke 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 survivors who achieve these goals. Methods: Prospective observational study of stroke patients treated in an interdisciplinary outpatient rehabilitation program addressing physical, cognitive, communicative, risk factor/stroke knowledge, self-efficacy, psychosocial, driving and vocational issues. Results: 190 consecutive patients(117 men, 73 women, average age 62(18-90), 66 aphasic) with baseline modified Rankin Scores of 5(1%); 4(25%); 3(56%); 2(15%); 1(3%), and average NIHSS score of 6(range 0-18) were treated between 12/2011-7/2019. 136 Patients suffered ischemic strokes and 54 had hemorrhages. Locations were: 65 left, 69 right, 26 bilateral hemisphere, 30 brainstem. 41% had MCA territory strokes. Of 104 patients working pre-stroke, 50% returned to work and an additional 7% were work capable upon completion of program. 95% of patients driving pre-stroke could not drive on admission. After training, 43%(67/157) returned to driving. Patients had improvements in all 9 domains of Stroke Impact Scale with SIS total score improving an average of 23%. Patients received an average of 33 physical therapy visits with average percent improvement of 72% and 41% on 6” walk and Berg Balance scores. Average percent improvement in Stroke Self Efficacy Scores was 29%. After individualized cardiovascular risk, stroke and medication education sessions with the Nurse Practitioner based on AHA guidelines and Life’s Simple 7’s curriculum, stroke and risk factor knowledge quiz scores improved an average of 29%. Average length of stay was 5(range .5-24) months. Multiple other demographic and outcome measures are collected. Conclusions: Outcome data show a community-based team rehabilitation program can successfully combine CV/stroke education with 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.