You have motivation wrong. Write up 100% recovery protocols on this and survivors will do the millions of reps needed, no external motivation required. You don't understand one goddamn thing about stroke survivors, DO YOU? The problem is stroke researchers are not motivated to solve stroke. What the fuck is your solution to that failure? We still don't know how to motivate stroke medical 'professionals' to solve stroke to 100% recovery!
Influence of motivation on rehabilitation outcomes after subacute stroke in convalescent rehabilitation wards
Taiki Yoshida1,2, 
Yohei Otaka1,3*, 
Shin Kitamura1,2, 
Kazuki Ushizawa1,3, 
Masashi Kumagai1, Jun Yaeda4 and 
Rieko Osu5- 1Tokyo Bay Rehabilitation Hospital, Department of Rehabilitation Medicine, Chiba, Japan
- 2Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan
- 3Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Aichi, Japan
- 4Graduate School of Comprehensive Human Science, University of Tsukuba, Tokyo, Japan
- 5Faculty of Human Sciences, Waseda University, Saitama, Japan
Background: The motivation for rehabilitation is important in encouraging stroke patients to participate in rehabilitation; however, its relationship with outcomes is not well known. In addition, changes in patient motivation during hospitalization have not been examined.
Aim: To examine the relationship between motivation and rehabilitation outcomes for subacute stroke patients and to investigate the changes in motivation.
Design: Prospective cohort study.
Setting: Subacute rehabilitation hospital.
Population: The study enrolled a consecutive sample of patients (n = 201) with stroke admitted to a subacute rehabilitation ward from October 2017 to March 2019.
Methods: The functional independence measure and motivation in stroke patients for rehabilitation scale was evaluated at admission; at one, two, and three months after admission; and at discharge. The effectiveness and efficiency of the functional independence measure were calculated as rehabilitation outcomes. The effect of motivation on outcomes and the change in motivation in stroke patients for rehabilitation scale scores over time were analyzed using a linear mixed model.
Results: The median (interquartile range) converted motivation in stroke patients for rehabilitation scale scores (converted to a range of 0–100) at admission; one, two, and three months after admission; and discharge was 86 (76–95), 83 (77–94), 81 (74–95), 81 (71–93), and 84 (75–95), respectively. The median (interquartile range) of effectiveness and efficiency of the functional independence measure from admission to discharge was 0.82 (0.68–0.91) and 0.41 (0.30–0.59), respectively. Motivation in stroke patients for rehabilitation scale scores were not significantly associated with the effectiveness and efficiency of the functional independence measure (p > 0.05). Motivation in stroke patients for rehabilitation scale scores were significantly lower at two (β = −3.1, 95% confidence interval [−5.3, −0.9], p = 0.005) and three (β = −4.4, 95% confidence interval [−7.3, −1.6], p = 0.002) months after admission than at admission.
Conclusion: Motivation might not directly affect rehabilitation outcomes assessed by the functional independence measure. Furthermore, many participants remained highly motivated, although their motivation decreased at one or three months after admission.
Clinical rehabilitation impact: Assumptions that rehabilitation is ineffective because of low motivation may not be correct. To examine the influence on outcomes, both motivation and daily activities should be considered.
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