Functional and Motor Outcome 5 Years After Stroke Is Equivalent to Outcome at 2 Months

Well shit, this shows you how pathetic our stroke rehab protocols are. We seem to have nothing that helps chronic survivors. Everyone is relying on the normal spontaneous recovery in the first 6-12 months and not able to get their patients any farther than that. That is truly pathetic. These people should never be paid for this lack of results.
http://stroke.ahajournals.org/content/early/2015/05/07/STROKEAHA.115.009421.abstract

Follow-Up of the Collaborative Evaluation of Rehabilitation in Stroke Across Europe

1. Sarah Meyer, MSc,
2. Geert Verheyden, PhD,
3. Nadine Brinkmann, BSc,
4. Eddy Dejaeger, PhD,
5. Willy De Weerdt, PhD,
6. Hilde Feys, PhD,
7. Andreas R Gantenbein, MD,
8. Walter Jenni, MD,
9. Annouschka Laenen, PhD,
10. Nadina Lincoln, PhD,
11. Koen Putman, PhD,
12. Birgit Schuback, MSc,
13. Wilfried Schupp, MD,
14. Vincent Thijs, PhD and
15. Liesbet De Wit, PhD

+ Author Affiliations

1. From the Department of Rehabilitation Sciences (S.M., G.V.,W.D.W., H.F.), Interuniversity Centre for Biostatistics and Statistical Bioinformatics (A.L.), Department of Neurosciences (V.T.), and Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (V.T.), KU Leuven, Leuven, Belgium; Fachklinik Herzogenaurach, Herzogenaurach, Germany (N.B., W.S.); University Hospital Pellenberg, Pellenberg, Belgium (E.D.); RehaClinic, Zurzach, Switzerland (A.R.G., W.J., B.S.); University of Nottingham, School of Medicine, Nottingham, United Kingdom (N.L.); Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium (K.P., L.D.W.); University of Central Lancashire, School of Health, Preston, United Kingdom (K.P.); Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium (V.T.); and Department of Neurology, University Hospital Leuven, Leuven, Belgium (V.T.).

1. Correspondence to Sarah Meyer, MSc, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, bus 1501, 3001 Leuven, Belgium. E-mail sarah.meyer@faber.kuleuven.be

Abstract

Background and Purpose—Recovery of patients within the first 6 months after stroke is well documented, but there has been little research on long-term recovery. The aim of this study was to analyze functional and motor recovery between admission to rehabilitation centres and 5 years after stroke.

Methods—This follow-up of the Collaborative Evaluation of Rehabilitation in Stroke Across Europe study, included patients from 4 European rehabilitation centres. Patients were assessed on admission, at 2 and 6 months, and 5 years after stroke, using the Barthel Index, Rivermead Motor Assessment Gross Function, Leg and Trunk function, and Arm function. Linear mixed models were used, corrected for baseline characteristics. To account for the drop-out during follow-up, the analysis is likelihood-based (assumption of missingness at random).

Results—A total of 532 patients were included in this study, of which 238 were followed up at 5 years post stroke. Mean age at stroke onset was 69 (±10 SD) years, 53% were men, 84% had ischemic strokes, and 53% had left-sided motor impairment. Linear mixed model analysis revealed a significant deterioration for all 4 outcomes between 6 months and 5 years (P<0.0001). Scores at 2 months were not statistically significant different from scores at 5 years after stroke. Higher age (P<0.0001) and increasing stroke severity on admission (P<0.0001) negatively affected long-term functional and motor recovery.

Conclusions—Five-year follow-up revealed deterioration in functional and motor outcome, with a return to the level measured at 2 months. Increasing age and increasing stroke severity negatively affected recovery up to 5 years after stroke.