[Relationship between type and amount of treatment and functional improvement in first-stroke during in-patients...

The effectiveness of ongoing rehabilitation services for post-acute stroke patients is poorly documented. The aim of the present study was describe the relationships between functional status at discharge and intensity of therapies, including occupational therapy, physical therapy, speech therapy and nursing care, during inpatient medical rehabilitation. All patients (30) admitted after a first stroke. The functional status of patients was observed by using the Functional Independence Measure on patient admission to rehabilitation and time per week during the hospitalisation. The neurological status of patients was observed by using the NIH Stroke Scale on patient admission to rehabilitation and at discharge. The study population included 30 patients of average 64.4 years; 60% were men; length of stay was 74 days. Statistical analysis were performed to check for intensity of therapies, discharge motor and cognitive function, the extent to which potential functional gains were achieved. Intensities of physical and speech therapies were not significant predictors of outcomes. Intensity of occupational therapy was significant predictor of outcomes (P = 0.04). We suggest that efficiently staged rehabilitation should vary the intensity and nature of services according to patients functional status, impairments, comorbid conditions and other clinical factors.