Predictive factors of functional gain in patients with first-ever stroke

الملخص EN

Objective : to identify patient characteristics in the early post stroke phase that could predict their functional recovery at discharge.

Methodology : Eighty-one individuals having first-ever stroke were included.

Patients were assessed at admission, underwent a comprehensive medical rehabilitation program, and then re-assessed again at discharge.

Assessment included stroke type, cardiovascular risk factors for stroke, associated neurological deficits, lesion size by MRI, total motoricity index (MI) of upper and lower extremities, motor function of the trunk assessed by Trunk Control Test (TCT), Mini Mental State Examination (MMSE) and Functional Independence Measure (FIM).

The functional recovery was measured by the FIM-gain score (discharge-admission).

Results : Total FIM score increased significantly from 72.85 ± 3.02 to 87.55 ± 3.13 (p < 0.001) with the average FIM-gain in total score was 14.7 ± 1.05.

The total FIM-gain is significantly affected by severity of the paresis, MRI size of the lesion and the presence of dysphagia, incontinence or hemineglect.

The total FIM-gain positively correlated with MI, MMSE and TCT at admission while inversely correlated with age of patients and onset-admission interval.

Among the predictors of functional recovery that were tested by means of regression analysis, younger age of the patients, TCT, MMSE and FIM score at admission are associated with higher gain total FIM scores.

Conclusions : Patients with stroke made significant functional gains and should be offered rehabilitation intervention.

Although age of the patient, TCT, MMSE and FIM score at admission predicts the functional gain, the initial functional status at admission assessed by FIM score, is the best predictor for functional recovery post rehabilitation.