Prediction of functional outcome in hemiplegic patients

A follow-up study of 40 hemiplegic patients two years after discharge from hospital was aimed at identifying variables capable of predicting general functional ability in everyday life (work, home, family and social life) and examining the relationship between levels of functioning and subjective evaluation of their rehabilitation state. The results showed that a composite measure of functioning ability was closely related to self-reports of satisfaction in significant areas of life: physical well-being, emotional security, satisfaction of family and social needs and vocational self-actualization. The best objective predictor of overall domestic and outdoor functioning was the primary ADL (eating, dressing, bathing, etc.). Other significant variables were ambulation (walking freely for 300 meters), sustaining mental load and emotional acceptance of disability. Predisposing and concurrent diseases (such as congestive heart failure, diabetes mellitus, hypertension and others) were not found to be of predictive value. The findings thus obtained could provide the physician with a good prognostic tool to evaluate the rehabilitation outcome of hemiplegic patients. They also suggested that intervention aimed at emotional acceptance of disability could facilitate the rehabilitation process.