Factors Associated with Functional Improvement at Discharge in Stroke Rehabilitation

Abstract

Objective: To study the factors associated with the functional improvement at discharge in stroke patients receiving inpatient rehabilitation.

Methods: Retrospective review of the medical records of all the stroke patients admitted to inpatient rehabilitation, Department of Rehabilitation Medicine, Siriraj Hospital from January 2005 to December 2005.

Results: There were sixty-one stroke patients, 39 males and 22 females, with a mean age 62.5 years old. Most of them lived with their spouses (61%) and had cerebral infarction (61%). The risk factors of stroke reported were hypertension (86.9%), dyslipidemia (63.9%), diabetes mellitus (34.4%), previous stroke (31.1%), heart disease (18%), smoking (8.2%) and regular alcoholic drinking (3.3%) respectively. The right and left side weakness were equally reported. The median duration of stroke before admission was 62 days. The disabilities at admission were urinary incontinence (39.3%), dysphagia (32.8%), and aphasia (26.2%). During the hospital stay, the complications which occurred were shoulder problems (41%), other musculoskeletal pain (34.4%), depression (26.2%), shoulder hand syndrome (13.1%), urinary tract infection (6.6%), and pneumonia (4.9%) respectively. Forty-seven patients (77%) gained functional improvement at discharge. The Chi-Square and Independent Sample T tests revealed the association between the functional improvement at discharge and urinary continence on admission (p=0.011), and duration of stroke within 3 months before admission to rehabilitation (p=0.011) with the odds ratio 5.9 and 5.3 respectively.

Conclusions: The functional improvement after the process of inpatient stroke rehabilitation was associated with the duration of stroke within 3 months before rehabilitation admission and urinary continence on admission.