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Examination of follow-up therapy in patients with stroke
Yong-Fang Kuo1, Glenn V Ostir, Carl V Granger
1Sealy Center on Aging, Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas 77555-0460, USA.
Objective:
Examine the patterns and effect of follow-up therapy for persons with stroke.
Design:
Retrospective analysis of national inpatient medical rehabilitation facilities and follow-up survey data from 1994 to 2001. A total of 45,164 patients received inpatient medical rehabilitation after a stroke. The mean age (+/- standard deviation) was 69.5 (+/-12.8) yrs, 48% were women, and 77% were non-Hispanic white. Average length of stay was 21.9 (+/-14.2) days.
Results:
The highest gain in FIM instrument ratings for follow-up therapy was associated with a discharge FIM rating of > or =65. Patients with FIM ratings > or =65 at discharge who received follow-up therapy gained an average of 19.4 points between discharge and follow-up assessment compared with a mean gain of 15.1 points for persons who did not receive follow-up therapy. Validity was examined using 100 bootstrap replications. The percentage of persons with FIM instrument scores of > or =65 receiving follow-up therapy increased from 38% in 1994 to 58% in 2001.
Conclusions:
The differences in postdischarge FIM gains between patients with and without follow-up therapy were greatest among patients with discharge FIM instrument ratings of > or =65. Compared with patients whose discharge FIM ratings were >65, patients with discharge FIM scores of > or =65 who underwent follow-up therapy demonstrated substantially greater average postdischarge FIM gains than those with FIM ratings of >65.