Early Rehabilitation in Acute Care Inpatient Wards May Be Crucial to Functional Recovery 3Months After Ischemic Stroke.

Abstract

Early rehabilitation in acute care inpatient wards may maximize functional outcome at 3months after stroke in survivors of stroke. It is unknown whether functional change during acute care hospitalization is significantly associated with functional recovery at 3months in survivors of acute stroke. The purposes of this study were to examine the association of the Barthel Index (BI) at 3months with functional change as measured with the Barthel Index (ΔBI) in an acute care inpatient ward and to identify the factors associated with ΔBI and who could benefit from an early rehabilitation program. In this prospective longitudinal study, 76 patients with ischemic stroke in an acute care inpatient ward received early rehabilitation of up to 2 sessions per day for 5 d/wk during their stay. Therapy density was calculated as the proportion of total therapy sessions completed. At admission and discharge, they were assessed with the BI and the Postural Assessment Scale for Stroke Patients (PASS). Demographic and health-related information was also collected. The Barthel Index (BI) was reassessed at 3months. ΔBI in the acute care inpatient ward significantly predicted the BI at 3months, over and above the other significant variables; in addition, therapy density and change in PASS were significantly associated with ΔBI. Patients with moderate initial functional dependence had the largest ΔBI, followed by the group with a more severe condition. ΔBI in acute care inpatient wards may be an important predictor of the BI at 3months. Therapy density and change in PASS were significantly associated with ΔBI. Survivors of acute stroke who receive up to 2 rehabilitation sessions per day for 5 d/wk early in their hospitalization have better functional recovery at 3months after stroke.