The efficacy of rehabilitation programs to facilitate recovery after acute stroke remains controversial. To further evaluate this issue, the records of 139 "middle-band" stroke survivors were reviewed retrospectively at admission to, discharge from, and one-year follow-up from inpatient rehabilitation. Patients were divided into two groups (out-patient [ O P] or no O P) based on their involvement in physical and occupational therapy services. A repeated measures ANOVA indicated that both groups made clinically and statistically significant improvements in all functional indices between stroke onset, discharge from inpatient rehabilitation, and follow-up: O P therapy: mobility F(1,46) = 1651, p<.0001; self-care F(1,47) = 1062, p<.0001; total F (1,47) = 1093, p<.0001; no O P therapy: mobility F(91,88) = 5643, p<.0001; self-care F(1,88) = 5722, p<.0001; total F(1,88) = 6733, p<.0001. Pairwise comparisons for all functional indices revealed that all statistically significant changes in function in the no O P therapy group occurred between stroke onset and discharge: self-care (p<.0001), mobility (p<.0001), and total (p<.0001). Pairwise comparisons of all indices in the O P therapy group revealed that all differences between stroke onset and discharge functional scores were at the p<.0001 level, and score differences between discharge from inpatient rehabilitation and follow-up were as follows: self-care (p<.05), mobility (p<.001), and total (p<.005). Receipt of O P therapy services was associated with a complete upper or lower extremity hemiplegia, unilateral neglect, impaired joint-position sense, or urinary incontinence. This study demonstrates that for a "middle band" of acute stroke patients, inpatient rehabilitation appears to be effective and that most patients maintain gains achieved during inpatient rehabilitation through one-year follow-up.
- Functional assessment
- Stroke rehabilitation