Prediction of Changes in Functional Outcomes during the First Year after Inpatient Stroke Rehabilitation

Oh fuck, when will management stop with the research that predicts failure to recover and do useful research like maybe: GETTING SURVIVORS RECOVERED!

I'd have all of management here fired!

Prediction of Changes in Functional Outcomes during the First Year after Inpatient Stroke Rehabilitation

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https://doi.org/10.1016/j.apmr.2024.02.051Get rights and content

Research Objectives

To describe patients’ meaningful changes in three functional domains (basic mobility [BA], daily activity [DA], and applied cognition [AC]) following discharge from inpatient stroke rehabilitation and to identify the predictors of the 1-year functional improvement.

Design

The longitudinal, multicenter, prospective cohort study.

Setting

The acute care wards of three hospitals in the greater Taipei area, Taiwan.

Participants

Five hundred patients with stroke in acute care wards (mean age=60±12.2 years, 62% male).

Interventions

Not applicable.

Main Outcome Measures

The Mandarin version Activity Measure for Post-Acute Care (AM-PAC) short forms assessed at discharge and 3-, 6-, and 12-months follow-up. The minimal detectable change (MDC) was used to categorize the score changes as “improved” and “nonimproved” between the four time points.

Results

The mean scores of the AM-PAC BM and DA subscales substantially increased within the first 3 months after discharge (86% participants were “improved”) and slightly increased during the subsequent 9 months (5∼26% participants were “improved”), whereas the mean score of the AC subscale decreased within the first 3 months and increased over the subsequent 9 months (22∼23% participants were “improved”). The BM, DA and AC scores at discharge were the dominant predictors of the subsequent functional improvement (p < 0.05). Patients at higher functional stages at discharge were more likely to have significant improvements.

Conclusions

Functional improvements in BM and DA were observed between discharge and 12 months, especially within the first 3 months; improvement in AC was evident during 3-12-months following discharge. The predictive ability of the AM-PAC for predicting functional improvement in three functional domains during the early, middle, and late stages of recovery were identified. These findings may help clinicians identify patients at risk of unfavorable long-term functional recovery and provide the patients with tailored interventions at the early stage of rehabilitation.