Functional improvement for patients with stroke receiving postacute care rehabilitation program.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Limited research exists on patient heterogeneity and functional recovery trajectories within postacute care cerebrovascular disease (PAC-CVD) programs.
• Understanding these factors is crucial for optimizing rehabilitation strategies for stroke survivors.

Purpose of the Study:

• To analyze group-based trajectories of functional recovery.
• To identify different functional improvement patterns among acute stroke patients in a PAC-CVD program.

Main Methods:

• Retrospective cohort study of 328 acute stroke patients in PAC-CVD programs (2014-2017).
• Latent profile analysis (LPA) used to categorize patients into high, medium, and low function groups at baseline.
• Analysis of variance and Chi-square tests examined associations between functional groups and patient characteristics.

Main Results:

• Baseline functional groups identified: High Function Group (HFG, 25.9%), Medium Function Group (MFG, 39.02%), and Low Function Group (LFG, 35.06%).
• Age, length of hospital stay, male sex, and lesion type were associated with being in the HFG.
• After 6 weeks, HFG patients remained high function (100%); MFG patients transitioned to HFG (49.04%) or remained MFG (50%); LFG patients transitioned to HFG (8.41%), MFG (57%), or remained LFG (34.58%).

Conclusions:

• Initial functional grouping can guide targeted PAC service utilization.
• Intensive PAC-CVD rehabilitation significantly improves functional recovery in acute stroke patients, with varying effectiveness over time.
• Further program development is needed to enhance patient independence.