Objective
Early
rehabilitation in acute care inpatient wards may maximize functional
outcome at 3 months after stroke in survivors of stroke. It is unknown
whether functional change during acute care hospitalization is
significantly associated with functional recovery at 3 months in
survivors of acute stroke. The purposes of this study were to examine
the association of the Barthel Index (BI) at 3 months with functional
change as measured with the Barthel Index (ΔBI) in an acute care
inpatient ward and to identify the factors associated with ΔBI and who
could benefit from an early rehabilitation program.
Methods
In
this prospective longitudinal study, 76 patients with ischemic stroke
in an acute care inpatient ward received early rehabilitation of up to 2
sessions per day for 5 d/wk during their stay. Therapy density was
calculated as the percentage of total therapy sessions completed. At
admission and discharge, they were assessed with the BI and the Postural
Assessment Scale for Stroke Patients (PASS). Demographic and
health-related information was also collected. The Barthel Index (BI)
was reassessed at 3 months.
Results
ΔBI
in the acute care inpatient ward significantly predicted the BI at
3 months, over and above the other significant variables; in addition,
therapy density and change in PASS were significantly associated with
ΔBI. Patients with moderate initial functional dependence had the
largest ΔBI, followed by the group with a more severe condition.
Conclusions
ΔBI
in acute care inpatient wards may be an important predictor of the BI
at 3 months. Therapy density and change in PASS were significantly
associated with ΔBI.
Impact
Survivors
of acute stroke who receive up to 2 rehabilitation sessions per day for
5 d/wk early in their hospitalization have better functional recovery
at 3 months after stroke.
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