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Benefit of inpatient multidisciplinary rehabilitation up to 1 year after stroke
Hajime Yagura1, Ichiro Miyai, Yujiro Seike
1Neurorehabilitation Research Institute, Bobath Memorial Hospital, Osaka, Japan. hiro-1@af6.so-net.ne.jp
Objective:
To analyze the benefit of inpatient multidisciplinary rehabilitation up to 1 year after stroke.
Design:
Retrospective cohort study.
Setting:
Inpatient rehabilitation hospital in Japan.
Participants:
A total of 1056 patients with stroke were divided into 3 groups based on the interval between stroke onset and admission to the rehabilitation hospital: group I, within 90 days (n=507, 48%); group II, 91 to 180 days (n=377, 36%); and group III, more than 180 days (n=172, 16%).
Interventions:
Not applicable.
Main Outcome Measures:
Functional outcome (A to D; independent to totally dependent) in walking, affected upper extremity, and activities of daily living (ADLs) and discharge disposition.
Results:
Walking status improved in 70.9% of nonambulatory patients in group I, in 54.8% in group II, and in 43.9% in group III. Similarly, ADLs improved in 66.7% of the totally dependent patients in group I and in approximately 50% in groups II and III. Functional gain in those with a totally nonfunctional upper extremity at admission was poor (29.7%). Initial functional categories affected each outcome (P<.0001). On discharge, 73.8% in group I and approximately 60% in groups II and III went home.
Conclusion:
Approximately half of all patients regained their abilities in walking and ADLs after inpatient multidisciplinary rehabilitation up to 1 year after stroke. However, there was considerable limitation in functional recovery of the affected upper extremity.
