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Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
Published on: February 22, 2020
Does postacute care site matter? A longitudinal study assessing functional recovery after a stroke
Leighton Chan1, M Elizabeth Sandel, Alan M Jette
1National Institutes of Health, Mark O. Hatfield Clinical Research Center, Rehabilitation Medicine Department, Bethesda, MD 20892, USA. chanle@cc.nih.gov
Archives of Physical Medicine and Rehabilitation
|November 6, 2012
Summary
Stroke patients may achieve better functional recovery with inpatient rehabilitation facility (IRF) care compared to other postacute options. This suggests IRF care could be crucial as healthcare reform reshapes postacute services.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Health Services Research
Background:
- Postacute care significantly influences stroke patient outcomes.
- Understanding the impact of different postacute care settings is crucial for optimizing recovery.
Purpose of the Study:
- To evaluate how the choice of postacute care setting affects functional outcomes for stroke survivors.
Main Methods:
- A prospective cohort study involving 222 stroke patients.
- Functional status was assessed at baseline and 6 months using the Activity Measure for Post Acute Care (AM-PAC).
- Compared outcomes across different postacute care pathways: home without services, home health/outpatient, inpatient rehabilitation facility (IRF), and skilled nursing facility (SNF).
Main Results:
- Patients discharged to an IRF demonstrated significantly higher functional scores at 6 months.
- IRF care resulted in at least 8 points higher AM-PAC scores compared to SNF care across all domains.
- Functional gains were also superior in 2 of 3 domains compared to home health/outpatient care.
Conclusions:
- Inpatient rehabilitation facilities (IRFs) appear to facilitate greater functional gains for stroke patients.
- These findings highlight the importance of IRF care in stroke recovery and have implications for evolving healthcare policies.
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