Predictive factors of functional gain in long-term stroke survivors admitted to a rehabilitation programme

Primary objective: To assess factors that may influence functional gain of patients with chronic sequelae of stroke. Research design: Prospective study of 290 stroke patients consecutively admitted to a rehabilitation setting. Methods and procedures: Functional Independence Measure Scale ( FIM) was used to assess functional capacity. Functional improvement registered during hospitalization ( FIM-gain score) was compared to demographic data, stroke sub-type, vascular risk factors, motor deficit, visual hemineglect, aphasia, level of response and sphincter control. FIM- gain score was classified as high-gain ( >= 22) and low-gain (<22). Main outcomes and results: Two hundred and fifty-two patients who had no prior rehabilitation and were capable of completing the rehabilitation programme were studied ( average age 58.4 +/- 13.9 years; 42.9% women). The mean time from stroke onset to admission was 271.5 days. Average FIM score at admission was 58.8 and at discharge was 81.6. Average FIM Gain was 23.6. The 38% patients admitted later than 6 months after stroke had an average FIM Gain of 19 vs 26 for patients admitted prior to 6 months. Significant predictors of functional improvement were time from stroke onset, age, sitting balance and level of responsiveness. Conclusion: The functional improvement scores in persons with stroke beginning a rehabilitation programme at a later stage are 73% of the scores obtained by patients beginning treatment in the first 6 months. FIM score improvement can be predicted by time since stroke onset, age, sitting balance and level of responsiveness.