Abstract WP318: Level And Predictors Of Participation In Stroke Patients Undergoing Inpatient Rehabilitation

Abstract

Background: The level of participation is an important factor influencing rehabilitation outcome. However, few studies have evaluated rehabilitation participation and its clinical predictors. The objectives of this study were to establish the level of participation in a cohort of stroke patients undergoing inpatient rehabilitation and define its clinical predictors. Methods: This was a prospective observational study of a cohort of first-ever stroke patients admitted to a rehabilitation centre over a 12-month period. The primary outcome measure was the level of rehabilitation participation as measured on the Pittsburgh Rehabilitation Participation Scale (PRPS). The PRPS was measured 1 week after admission to and 1 week before planned discharge from inpatient rehabilitation. Other outcome measures evaluated included National Institute of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), Elderly Cognitive Assessment Questionnaire (ECAQ), Centre for Epidemiologic Studies -Depression Scale (CES-D), Fatigue Severity Scale (FSS), Lubben Social Network Scale-Revised (LSNS-R) and health attitudes and beliefs. Results: A total of 122 stroke patients were studied. The mean PRPS score on admission was relatively high at 4.36(0.9) on admission and this improved to 4.65(0.79) on before planned discharge.(p<0.001). On multivariate analysis, the mean PRPS score on admission was predicted by admission FIM, EACQ and FSS scores but not by age, gender, depression, social support or health attitudes and beliefs. Conclusions: Patients with lower levels of participation were more likely to be functionally dependent, cognitively impaired and have more fatigue. We suggest that apart from cognition, fatigue should be routinely screened in stroke patients undergoing rehabilitation.