Main outcomes of stroke rehabilitation: A multi-centre study in Thailand

Abstract

To estimate the efficiency of inpatient rehabilitation for patients after stroke in Thailand. Multi-centre, prospective study. Patients after stroke, aged >or= 18 years, with stable medical signs, able to follow 1-step commands and to sit for at least 30 min. Main outcomes included Barthel Index (BI) scores, BI effectiveness, BI efficiency, length of stay, Thai Hospital Anxiety and Depression Scale (HADS) scores, and quality of life. Of a total of 327 patients, 285 completed the programmes, with a mean length of stay of 27.3 days. Mean age was 62.1 (standard deviation (SD) 12.1) years and 59% of patients were male. Mean BI scores on admission and at discharge were 7.48 (SD 3.96; range 0-19) and 13.27 (SD 4.86; range 0-20), respectively. The change score was 5.79 (SD 3.89) and the efficiency of functional score was 0.28 points/day. Using multivariate analysis, factors associated with change in BI score were age, previous stroke and length of stay. Sixty-four patients (25.5%) had anxiety and 95 (37.8%) had depression on admission. At discharge, the numbers of patients with anxiety and depression decreased to 17 (6.8%) and 41 (16.3%), respectively. The quality of life scores at discharge were significantly higher than those on admission. Inpatient rehabilitation enabled stroke patients to reach optimal functional ability, and improved psychological status and quality of life.