Subacute Inpatient Rehabilitation Research Articles

Unmet rehabilitation needs in the first 6 months post-injury in a trauma centre population with moderate-to-severe traumatic injuries.

To describe the needs for subacute inpatient rehabilitation and community-based healthcare services, rehabilitation, and social support in patients with moderate-to-severe traumatic injury in the first 6 months post-injury. Further, to explore associations between sociodemographic and clinical characteristics and unmet needs. Multicentre prospective cohort study. Of 601 persons (75% males), mean (standard deviation) age 47 (21) years, admitted to trauma centres in 2020 with moderate-to-severe injury, 501 patients responded at the 6-month follow-up and thus were included in the analyses. Sociodemographic and injury-related characteristics were recorded at inclusion. Estimation of needs was assessed with the Rehabilitation Complexity Scale Extended-Trauma and the Needs and Provision Complexity Scale on hospital discharge. Provision of services was recorded 6months post-injury. Multivariable logistic regressions explored associations between baseline variables and unmet inpatient rehabilitation and community-based service needs. In total, 20% exhibited unmet needs for subacute inpatient rehabilitation, compared with 60% for community-based services. Predictors for unmet community-based service needs included residing in less central areas, profound injury severity, severe head injury, and rehabilitation referral before returning home. Inadequate provision of healthcare and rehabilitation services, particularly in the municipalities, resulted in substantial unmet needs in the first 6 months following injury.

Efficacy of Intervention of Participation and Executive Functions (I-PEX) for Adults Following Traumatic Brain Injury: A Preliminary Pilot Randomized Controlled Trial

Background Participation restrictions following traumatic brain injury are associated with executive function (EF) deficits (EFDs). The subacute recovery phase’s specific characteristics (enhanced brain plasticity and impaired self-awareness) and contextual factors (inpatient setting) warrant adjusting cognitive rehabilitation protocols. The Intervention of Participation and Executive Functions (I-PEX) was designed to improve EFDs during subacute inpatient rehabilitation. Objective To investigate the I-PEX’s preliminary efficacy to improve EFDs during the performance of complex daily activities and enhance self-awareness, cognitive self-efficacy, participation, and quality of life postdischarge. Methods A pilot pre-, post-, and follow-up double-blind randomized controlled trial with 25 participants randomly allocated to the I-PEX (n = 13) or treatment-as-usual (n = 12) group. Cognitive assessments were administered pre- and postintervention, and quality of life and participation questionnaires 1-month postdischarge. Data analysis included repeated measures analysis of variance mixed design and independent t-tests, extracting effect sizes. Results Significant group-by-time interaction effect with a medium effect size was found for the primary outcome measure; EFs manifested in complex daily activities, indicating a larger improvement for the experimental group. The group effect was not significant. The experimental group’s mean delta score (pre–post improvement) was significantly higher (1.75 ± 2.89; t(23) = 2.52, P = .019), with a large effect size (d = 1.012, 95% confidence interval [0.166-1.840]). We found no significant group and interaction effects for EFs, self-awareness, and cognitive self-efficacy or no significant differences in participation or quality of life postdischarge. Conclusions Results provide initial evidence for the I-PEX efficacy in treating EFDs in the subacute phase and could help determine effect size for future studies. Clinical Trial Registry Number: ClinicalTrial.gov NCT04292925.

Subacute prognosis of oral nutrition (SPOON): Development of a multivariable prognostic model for complete oral intake in tube-fed subjects with acquired brain injury

Enteral feeding is very common following an acquired brain injury. However, no prognostic models for oral food intake have been developed for subacute rehabilitation. The aim of this study was to develop a prognostic model and online tool, coined "subacute prognosis of oral nutrition" (SPOON), for complete oral intake in tube-fed subjects with acquired brain injury. The model was developed using routinely gathered clinical data from a cohort of 1233 adult patients who were tube-fed at admission for sub-acute inpatient rehabilitation. Candidate predictors were included based on scientific evidence and their availability in the medical records within the first days following admission. The outcome was time until achieving complete oral food intake without any tube-feeding supplements. Time until complete oral intake was analyzed by discrete time-to-event analysis with logit-link and presented as daily odds ratios (OR) with 95% confidence intervals (CI). The following predictors of complete oral intake were included in the model: age, diagnosis, cuffed tracheostomy tube, days from injury to admission for rehabilitation, and the Early Functional Abilities (EFA) sum score. Multiple adjusted analyses were performed stratified by cuffed tracheostomy tube status. Some of the strongest predictors of complete oral intake were age 18-40 years, OR 1.99 (95%CI: 1.53; 2.59); 0-2 weeks since injury, OR 3.75 (95%CI: 2.72; 5.16); and EFA 61-100 (slight/no disturbance in function), OR 5.81 (95%CI: 4.47; 7.55). The online prognostic tool SPOON was evaluated in a usability study. Based on feedback from clinicians, the tool was further refined to enable extraction of data for prediction directly from medical records. The objective of SPOON is to complement the planning of rehabilitation initiatives and inform discussions to determine if a percutaneous endoscopic gastrostomy (PEG) tube should be inserted. SPOON is being implemented locally, but external validation based on appropriate data modeling is warranted before further clinical implementation.

Patient- and proxy-perceptions on functioning after stroke rehabilitation using the 12-item WHODAS 2.0: a longitudinal cohort study

Purpose To analyse longitudinally patient- and proxy-perceptions on stroke survivors’(SSs’) functioning using the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS) after subacute inpatient stroke rehabilitation. Methods Sixty-five SSs and their significant others(proxies) responded to WHODAS questionnaire at discharge and 9 to 50 months later. Self-WHODAS ratings were compared with corresponding proxy-perceptions and informal ratings on self-reported functional recovery. Results On average, SSs’ functioning improved after discharge, except according to self-WHODAS ratings of those with severe stroke. Individual changes were, however, notable. Association between time and change was statistically insignificant. SSs perceived greatest improvements in walking, household tasks, community life and working ability. The only items showing slight deterioration were emotions and relationships. In parallel, proxies rated all items except emotions and relationships improved. At discharge, proxies rated SSs’ functioning more impaired than SSs themselves, mostly regarding those with severe stroke. Still, inter-rater reliability was very strong and increased significantly with time (ICC 0.799 vs. 0.979 at follow-up). Ninety percent of SSs with improved functioning according to self-WHODAS reported better functioning also in the informal questionnaire. Conclusion WHODAS showed improvements in SSs’ functioning 9-50 months after discharge from subacute stroke rehabilitation. Improvements were in line with proxy-perception and self-reported functional recovery. IMPLICATIONS FOR REHABILITATION Stroke survivors’ functioning improved significantly during the 9-50 months follow-up after subacute inpatient stroke rehabilitation. Stroke survivors perceived slightly less difficulties in their functioning compared to evaluations by proxies. Strong correlation between patient- and proxy-perceptions on stroke survivors’ functioning strengthened from subacute to chronic phase of stroke recovery. The 12-item WHODAS 2.0 seems to be a valuable patient- and proxy-reported outcome measure to assess longitudinal changes in stroke survivors’ functioning after stroke.

Frequency and Characteristics of Medical Complications in Rehabilitation Settings: A Scoping Review.

To synthesize the available evidence on medical complications occurring in adult patients in subacute inpatient rehabilitation, and to describe the impact on subacute length of stay and readmission to acute care. Scoping review. Adult patients, within the inpatient rehabilitation environment, who experienced medical complications, clinical deterioration and/or the requirement of transfer to acute care. A systematic search of MEDLINE and CINAHL electronic databases was undertaken to identify primary research studies published in English and French between 2000 and 2021. Study reporting followed the standards indicated by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist (PRISMA-ScR). A total of 47 studies were identified for inclusion. Key results included differences in the type and frequency of complications according to admission type, the proportion of patients experiencing at least 1 complication, and complications associated with transfer to acute care. Patients admitted for inpatient rehabilitation are at high risk of medical complications and may not be medically stable during their admission, requiring care by clinicians with expertise in functional rehabilitation, and ongoing management by members of the multidisciplinary team with expertise in acute general medicine, infectious diseases and recognition and response to clinical deterioration.

Multiplex array analysis of serum cytokines offers minimal predictive value for cognitive function in the subacute phase after stroke.

The effects of inflammation on post-stroke cognitive function are still unclear. This study investigated the correlation between the Th17-related cytokines in peripheral blood and post-stroke cognitive function after ischemic stroke in the subacute phase. A retrospective cohort study. Academic acute inpatient rehabilitation facility. One hundred and fourteen patients with first ischemic stroke were categorized as the poor cognitive recovery group (n = 58) or good cognitive recovery group (n = 56) based on their cognitive MRFS efficiency. All subjects received routine physical, occupational, and speech-language pathology therapy. Serum cytokines/chemokine (IL-1 β, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-12p70, IL-13, IL-15, IL-17A, IL-17E, IL-17F, IL-21, IL-22, IL-23, IL-27, IL-28A, IL-31, IL-33, GM-CSF, IFN-γ, MIP-3 α, TNF-α, and TNF-β) levels were measured in duplicate using Human Th17 magnetic bead panel and multiplex array analysis (Luminex-200 system). The primary functional outcome was a gain in functional independence measure (FIM) cognitive subscore at discharge. The secondary outcome measures were FIM total score at discharge, length of stay in the hospital, and discharge destination. Cognitive Montebello Rehabilitation Factor Score (MRFS) and cognitive MRFS efficiency were calculated. Demographic and clinical characteristics were obtained from the medical record. The good cognitive recovery group had an interesting trend of higher IL-13 than the poor cognitive recovery group (good cognitive recovery group 257.82 ± 268.76 vs. poor cognitive recovery group 191.67 ± 201.82, p = 0.049, unit: pg/ml). However, Pearson's correlation analysis showed no significant correlation between cytokine levels and gain of cognition, cognitive MRFS, or cognitive MRFS efficiency. Receiver operating characteristic (ROC) analysis of cytokines also suggested a low accuracy of prediction as a predictor for post-stroke cognitive recovery improvement. Our preliminary findings suggested that the level of serum cytokines had minimal predictive value for the recovery of cognitive function during the subacute inpatient rehabilitation after stroke.

The safety and feasibility of early cardiorespiratory fitness testing after stroke.

Cardiorespiratory fitness testing is recommended as part of a pre-exercise evaluation to aid the programming of safe, tailored cardiorespiratory fitness training after stroke. But there is limited evidence for its safety and feasibility in people with stroke with varying impairment levels in the early subacute phase of stroke recovery. To assess the safety and feasibility of cardiorespiratory fitness testing in the early subacute phase after stroke. A sub-study of a larger single service, multi-site, prospective cohort feasibility study (Cardiac Rehabilitation in Stroke Survivors to Improve Survivorship [CRiSSIS]). Private subacute inpatient rehabilitation facilities. Consecutive admissions of people with ischemic stroke admitted to subacute rehabilitation facilities. Not applicable. Safety was determined by the occurrence of adverse or serious adverse events. Feasibility was determined by assessing the (1) number of participants recruited and (2) number of participants able to complete the fitness test. Between April 2018 and December 2019, a total of 165 people with stroke were screened to participate; 109 were eligible and 65 were recruited. Of the 62 who completed testing, 41 participants were able to complete a submaximal fitness test at a median of 12 days post-stroke. One minor adverse event was recorded. Of the 21 participants unable to complete the fitness test; 4 declined to complete the test, 9 were unable to commence the test, and 8 were unable to complete the first stage of the protocol due to stroke-related impairments. Participants with mild stroke, greater motor and cognitive function, and fewer depressive symptoms were more likely to be able to complete the cardiorespiratory fitness test. Cardiorespiratory fitness testing was safe for most people with mild-to-moderately severe ischemic stroke and transient ischemic attack in the early subacute phase, but only two-thirds of the participants could complete the test.

Computerized social cognitive training in the subacute phase after traumatic brain injury: A quasi-randomized controlled trial

Objectives To assess the usefulness of a computerized tasks module designed for the rehabilitation of social cognition (SC) in acquired brain injury. Methods Quasi-randomized controlled trial (ClinicalTrials.gov:NCT03479970) involving 45 patients with moderate-severe traumatic brain injury (TBI) in a subacute inpatient rehabilitation hospital. The experimental group (n = 28) received treatment with a computerized SC module in combination with a non-SC module. The control group (n = 26) only received a treatment with non-SC module. Results Intragroup comparisons showed that the experimental group had better results for all SC measures, except for International Affective Picture System (IAPS). The control group improved for Facial Expressions of cEmotion-Stimuli and Tests (FEEST) and Moving Shapes Paradigm (MSP), showing no changes with respect to pretreatment in IAPS, MSP and Reading the Mind in the Eyes Test (RMET). Intergroup comparisons did not present differences between the two groups for pretreatment measures. Post-treatment comparison showed that the experimental group obtained better results for RMET than the control group. Conclusion The computerized SC module was useful for the rehabilitation of SC in patients with moderate-severe TBI in the subacute phase. The group that received combined rehabilitative treatment (SC + non-SC) obtained better results for SC than the group that received treatment intended only for non-SC.

A self-directed upper limb program during early post-stroke rehabilitation: A qualitative study of the perspective of nurses, therapists and stroke survivors.

IntroductionThis study aimed to explore the perspective of nurses, therapists and stroke survivors on the performance of upper limb self-exercise and use outside therapy during early inpatient stroke rehabilitation.MethodsA descriptive qualitative approach was used in focus groups with nurses (n = 21) and therapists (n = 8), as well as in-depth semi-structured interviews with stroke survivors (n = 8) who were undergoing subacute inpatient stroke rehabilitation. Inductive thematic analysis of data was performed according to participant group.ResultsNurses and therapists perceived that stroke survivors played a central role in determining the success of a self-directed upper limb program. Nurses perceived that stroke survivors needed a lot of prompting to be motivated to perform self-directed upper limb therapy outside therapy. Therapists perceived that not all stroke survivors would be able to perform self-directed upper limb therapy and deemed it important to consider stroke survivor factors before commencing a program. Although some stroke survivors expressed initial reservations with performing self-practice, many indicated that they would participate in the self-directed upper limb program because they wanted to recover faster.ConclusionA difference between the perspective of nurses/therapists and stroke survivors towards self-directed upper limb performance outside therapy was found. Deeper stroke survivor engagement and a shift in rehabilitation culture to encourage stroke survivor autonomy are important considerations for a self-directed upper limb program. Teamwork amongst healthcare professionals and families is essential to support stroke survivors to participate in a self-directed upper limb program during early inpatient stroke rehabilitation.

Functional and ambulatory benefits of robotic-assisted gait training during early subacute inpatient rehabilitation following severe stroke.

Functional and ambulatory benefits of robotic-assisted gait training during early subacute inpatient rehabilitation following severe stroke.

A qualitative interview study on how people with incomplete spinal cord injury experience high-intensity walking exercise

Study designQualitative, in-depth research interviews.ObjectiveTo provide new insight into how people with a recent incomplete spinal cord injury (SCI) experience high-intensity walking exercise after discharge from subacute inpatient rehabilitation.SettingInformants for this interview study participated in a previous randomized controlled trial (RCT) that was conducted at Sunnaas Rehabilitation Hospital, Norway.MethodsFour individual face-to-face interviews were conducted with the participants in natural setting. The interviews were analyzed through systematic text condensation and discussed in the context of experiences of bodily changes.ResultsFour themes emerged that described positive but also challenging bodily experiences related to performing high-intensity walking exercise: “Expectations and motivation”—reasons for participating, “Challenging bodily changes”—impacts on walking ability, “Adaptation strategies”—achieving the high-intensity target level, and “Integrating exercise into a new daily life”—combining participation, new body and new life.ConclusionsThis study indicates the importance of participating in a specific exercise program at discharge from subacute inpatient rehabilitation for ambulant people with SCI. However, high-intensity walking exercise may be too demanding to perform during this time period. The insights from the study provide new knowledge that can contribute to improving clinical rehabilitation practice.

Guillain Barre Syndrome and Posterior Reversible Encephalopathy Syndrome as Complications of Coronavirus Disease-2019

Guillain-Barre syndrome (GBS) is a rare inflammatory disorder that most commonly occurs as a response to a preceding infection. Although GBS is most commonly associated with Campylobacter jejuni infection, several reports have indicated a relationship between the novel coronavirus disease-2019 (COVID-19) and GBS. Here, we present a case of a 72-year-old female diagnosed with COVID-19 who developed progressive lower and upper extremity weakness one month following her COVID-19 diagnosis. Magnetic resonance imaging (MRI) of the spine confirmed the diagnosis of GBS and her hospital course was further complicated by posterior reversible encephalopathy syndrome (PRES). She responded well to intravenous immunoglobulin (IVIG) and subacute inpatient rehabilitation.

Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures

Introduction No single tool is able to distinguish fallers from non-fallers. The aim of this study was to detect subacute stroke inpatients at higher risk for falls, predictors for the number of falls and near falls and the impact of these incidents on functional outcome. Methods An observational prospective cohort study comparing clinical differences between non-fallers, onetime and repeat fallers. Bivariate and multivariate Poisson regression analyses with length of stay as an offset variable were conducted. Results Fallers had mostly intermediate level of impairment and disability (NIHSS, FIM, mRS, the ICF minimal generic data set). The onetime fallers who were oldest, most disabled and most often institutionalised achieved the same functional improvement as the non-fallers, however, after significantly longer inpatient rehabilitation. The repeat fallers who were youngest and had the longest rehabilitation in-stay, achieved equal functioning as the non-fallers having faster motor gain and the greatest overall functional improvement compared to the other two subgroups. Conclusions Right hemispheric stroke, previous myocardial infarction and shorter time from stroke onset were independent predictors for the number of incidents. In the future, larger studies are recommended to investigate fall rate and different severities of incidents, falls and near falls separately.

Sarcopenic obesity and function in women with subacute hip fracture: a short-term prospective study.

The prognostic role exerted by the concurrent presence of sarcopenia and obesity after hip fracture has not been elucidated. To assess the effect of sarcopenic obesity on ability to function in women with subacute hip fracture. Short-term prospective study. Rehabilitation hospital. Women with subacute hip fracture. At admission, grip strength, by a Jamar dynamometer, and body composition by dual-energy x-ray absorptiometry were assessed. Sarcopenia was defined according to the criteria released by the European Working Group for Sarcopenia in Older People in 2019, with both grip strength <16 kg and appendicular lean mass (aLM)<15 kg. Alternatively, aLM/(height)2<5.5 kg/m2 was substituted for aLM<15 kg to confirm sarcopenia in the women with grip strength <16 kg. Obesity was diagnosed with fat mass exceeding 40% of total body mass. Function was assessed by the Barthel index. We assessed 183 of 200 women. Sarcopenic women had lower Barthel index scores assessed at the end of subacute inpatient rehabilitation (U=300,0; z=-4.3; P<0.001) and lower Batrhel index effectiveness (U=310,0; z=-4.2; P<0.001) than non-sarcopenic women. Conversely, we found no significant differences in function between obese and non-obese women. The concurrent presence of sarcopenia and obesity did not worsen the functional prognosis versus the presence of isolated sarcopenia. After adjustment for Barthel index scores before rehabilitation, age, hip-fracture type and cognitive impairment, sarcopenia was significantly associated with Barthel index scores (P=0.001) and Barthel index effectiveness (P<0.001), whereas obesity was not. The results did not materially change when aLM/(height)2<5.5 kg/m2 was substituted for aLM <15 kg to confirm sarcopenia in the women whose handgrip strength was <16 kg. The concurrent presence of obesity did not worsen the negative prognostic role of sarcopenia in the short-term recovery of ability to function after hip fracture in women. In women with subacute hip fracture, sarcopenia but not obesity should be assessed to contribute to the prediction of the short-term functional outcome.

Sarcopenia Is Associated With Reduced Function on Admission to Rehabilitation in Patients With Diabetes.

This work aims to estimate the prevalence of sarcopenia and to investigate the association between sarcopenia and functional performance in patients with and without diabetes admitted for inpatient rehabilitation. Consecutive patients admitted to the subacute inpatient rehabilitation unit at St Vincent's Hospital Melbourne, Australia (November 2016 to March 2020) were prospectively recruited into this cross-sectional study. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People 2018 algorithm. Participants' functional performance was measured by the total Functional Independence Measure, motor Functional Independence Measure, and the Short Physical Performance Battery. The association between sarcopenia and functional performance was investigated using quantile regression. Of 300 participants, 49 (16%) had a history of diabetes and 44 (14.7%) were diagnosed with sarcopenia. No significant difference in the prevalence of sarcopenia between patients with or without diabetes was identified (11/49, 22.5% vs 33/251, 13.2%, P = .12). In patients with diabetes, those with sarcopenia had significantly reduced functional performance compared to those without sarcopenia on Functional Independence Measure, motor Functional Independence Measure, and the Short Physical Performance Battery, whereas in patients without diabetes no significant difference between patients with and without sarcopenia were identified for either functional performance measure (all P values for interaction < .005). The diagnosis of sarcopenia was associated with a reduced functional performance on admission to inpatient rehabilitation in patients with diabetes, but not in those without diabetes. Further investigation is needed into the progress of patients with dual diagnoses of diabetes and sarcopenia in inpatient rehabilitation.

Participation and Executive Functions in Adults Following Traumatic Brain Injury During Sub-Acute Inpatient Rehabilitation

Participation and Executive Functions in Adults Following Traumatic Brain Injury During Sub-Acute Inpatient Rehabilitation

Comparison of functional recovery and outcome at discharge from subacute inpatient rehabilitation in patients with right or left stroke with and without contralateral spatial neglect.

To compare to what extent the presence of contralateral spatial neglect affects functional recovery and outcome among patients with right or left stroke after subacute inpatient rehabilitation. Observational cohort study comparing functional improvement and outcome. The same admission data-set was used as in part 1 of this study. Right and left stroke rehabilitants with equally mild neglect and those without neglect (a total of 4 subgroups) all improved proportionally as much, but those with neglect, irrespective of stroke side needed a longer stay in inpatient rehabilitation. At discharge, total disability did not differ significantly between the 2 neglect subgroups, but those with left stroke had significantly lower Functional Independence Measure cognitive sub-score and score in communication. Rehabilitants with neglect, irrespective of stroke side had higher motor, cognitive and total disability and were more often institutionalized than those without neglect. Mild neglect did not impair recovery after right or left stroke, but rehabilitants with neglect were more disabled and needed a longer rehabilitation inpatient stay than those without neglect.

Comparison of accelerometer-based arm, leg and trunk activity at weekdays and weekends during subacute inpatient rehabilitation after stroke

To determine whether there are differences in arm, leg and trunk activity measured by acceleration between weekdays and weekends in people undergoing rehabilitation in the subacute stage after stroke. Cross-sectional study. Twenty-eight individuals with stroke (mean age 55.4 years; severe to mild impairment) and 10 healthy controls. A set of 5 3-axial accelerometers were used on the trunk, wrists and ankles during 2 48-h sessions at weekdays and over a weekend. Day-time acceleration raw data were expressed as the signal magnitude area. Asymmetry between the affected and less-affected limb was calculated as a ratio. Participants with stroke used their both arms and legs less at weekends than on weekdays (p< 0.05, effect size 0.32-0.57). Asymmetry between the affected and less-affected arm was greater at weekends (p < 0.05, effect size 0.32). All activity measures, apart from the less-affected arm on weekdays, were lower in stroke compared with controls (p < 0.05, effect size 0.4-0.8). No statistically significant differences were detected between weekday and weekend activity for the control group. One-third of participants perceived the trunk sensor as inconvenient to wear. Increased focus needs to be applied on activities carried out during weekends at rehabilitation wards.

Stroke survivor activity during subacute inpatient rehabilitation: how active are patients?

Being active following stroke is recommended, but inactivity is common. The current study aimed to observe stroke survivors physical, social and cognitive activities in a large regional inpatient rehabilitation centre. Patients were observed over 8 separate days at 10-min intervals between 8 a.m. and 8 p.m. Patients were engaged in any form of activity 59.9% of the time and in therapy 4.6% of the time. Patients were inactive and alone 34.3% of the time. Activity levels were weakly associated with patients' functional abilities (Spearman's ρ≤0.39). Independent walkers spent a higher proportion of the day physically active (37.5%) compared with nonindependent walkers (30.6%) (P=0.019). Days since stroke was not correlated with patient activity levels. Initiatives to increase activity during inpatient rehabilitation appear to be warranted.

Neurobehavioral disability in stroke patients during subacute inpatient rehabilitation: prevalence and biopsychosocial associations

ABSTRACTBackground and Objectives: There are scarce data on post-stroke neurobehavioral disability (NBD). The aim of this study was to identify the prevalence of NBD in a subacute inpatient stroke population and examine potential associations with demographic, stroke-related, functional and psychosocial variables.Methods: 82 survivors of stroke were consecutively recruited during their inpatient rehabilitation admission. Nursing staff rated NBD in patients using the St Andrews –Swansea Neurobehavioral Outcome Scale (SASNOS). Measures of patient functional independence (FIM), cognition (MoCA), and mood symptoms (HADS) were collected in addition to nursing reports of whether observed NBD negatively impacted on the patient or those around them.Results: NBD relating to interpersonal relationships (44.4% of participants) and cognition (52.4%) were highly prevalent within the sample while NBD relating to inhibition (1.2%), aggression (3.6%), and communication (2.5%) were relatively rare. Presence of NBD was significantly associated with reduced functional independence (rs=0.39, p < 0.01) and associated with trends in cognitive impairment (rs=0.29, p = 0.03), increased anxiety (rs=-0.43, p = 0.02) and depressive symptoms (rs=-0.43, p = 0.02). Presence of NBD was significantly correlated with negative impact to the patient and those around them across all SASNOS domains (rs range 0.42 - 0.45, all p ≤ 0.01).Conclusions: NBD is common within a subacute stroke inpatient population, particularly interpersonal and cognitive difficulties and preliminary analyses indicate associations with reduced functional ability, cognition and mood. There is a need to provide education and support to clinicians to facilitate routine assessment and management of NBD following stroke.