Characterizing speech and language pathology outcomes in stroke rehabilitation

Objectives: To describe a subset of speech-language pathology (SLP) patients in the Post-Stroke Rehabilitation Outcomes Project and to examine outcomes for patients with low admission FIM levels of auditory comprehension and verbal expression. Design: Observational cohort study. Setting: Five inpatient rehabilitation hospitals. Participants: Patients (N=397) receiving poststroke SLP with admission FIM cognitive components at levels 1 through 5. Interventions: Not applicable. Main Outcome Measure: Increase in comprehension and expression FIM scores from admission to discharge. Results: Cognitively and linguistically complex SLP activities (problem-solving and executive functioning skills) were associated with greater likelihood of success in low- to midlevel functioning communicators in the acute poststroke rehabilitation period. Conclusions: The results challenge common clinical practice by suggesting that use of high-level cognitively and linguistically complex SLP activities early in a patient's stay may result in more efficient practice and better outcomes regardless of the patient's functional communication severity level oil admission.