The influence of stroke rehabilitation units on functional recovery from stroke

And once again there is no discussion of the actual damage diagnosis to correlate to functional recovery. Even I can figure out that if I have a pea sized dead area surrounded by a softball sized penumbra; that will recover better than a softball sized dead area like I have. When are stroke doctors going to use the scientific method to determine cause and effect?
http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102237092.html
OBJECTIVES: To determine what factors (patient characteristics, process of care, and structure variables) are predictors of patient outcome and recovery from stroke. The ability to predict who will benefit most and from what type of Rehabilitation will help physicians make the best treatment choices for their patients and give patients and their families the most realistic outlook for recovery from stroke. METHODS: Patients admitted to the stroke rehabilitation program from the acute care hospitals were examined over a 5 year period (1993-1997). Information on type of stroke, admission and discharge Functional Independence Measure (FIM) scores, length of stay, length of waiting time for admission, comorbidities, complications, and pre-stroke and post-stroke demographics were collected. These variables were used to determine predictors for recovery from stroke (improvement in FIM), predictors of complications, and patient discharge deposition. RESULTS: Preliminary analysis reveals that the presence of dysarthria, dysphagia, or inattention increases the probability of long-term dependency. Admission FIM scores are good predictors of discharge deposition and stroke outcome. Patients requiring institutionalized long term care appear to be at greater risk of developing reflex sympathetic dystrophy, severe spasticity, depression and deep vein thrombosis. CONCLUSIONS: Pre-admission FIM score appears to be the best predictor of stroke outcome. Patients admitted with a FIM between 47 and 96 show the greatest functional improvement but may still require institutional care. Patients with a FIM of 96 or above are most likely to be discharged home or to a residential setting; patients with an admission FIM less than 47 are most likely to require long-term institutionalization.