Does the NRS Capture Changes in Communication during Inpatient Stroke Rehabilitation?

Area of Science:

• Neurology
• Rehabilitation Medicine
• Speech-Language Pathology

Background:

• The National Rehabilitation Reporting System (NRS) is mandated in Ontario for measuring stroke patient progress.
• The NRS comprises the functional independence measure (FIM) and Canadian Institute for Health Information (CIHI) communication items.
• The necessity of supplementary speech-language pathology outcome tools for stroke communication assessment remains debated.

Purpose of the Study:

• To determine if FIM and CIHI communication items adequately quantify stroke rehabilitation gains.
• To ascertain whether additional outcome measures are needed for stroke communication assessment.

Main Methods:

• Retrospective analysis of 1252 stroke patient records.
• Data collected from patients discharged from inpatient rehabilitation between 2006 and 2011.
• Utilized functional independence measure (FIM) and CIHI communication subscale scores.

Main Results:

• Statistically significant improvements were observed in total FIM scores (72.68 to 96.39, P<.001).
• Significant gains were noted in both expression (4.61 to 5.35, P<.001) and comprehension (4.69 to 5.33, P<.001) subscales.
• The most affected patients showed the greatest improvements, irrespective of stroke severity.

Conclusions:

• The FIM and CIHI communication items are sufficient for assessing communication outcomes in stroke rehabilitation.
• Additional speech-language pathology outcome measurement tools are not currently required.
• Further research is needed to evaluate the clinical significance of observed improvements.