FUNCTIONAL OUTCOME IN STROKE INPATIENT REHABILITATION - PREDICTING NO, LOW AND HIGH RESPONSE PATIENTS

The aims of this study were: (1) to identify reliable prognostic facto rs for detecting subgroups of no, low and high response in consecutive patients admitted for rehabilitation of first stroke sequelae, and (2 ) to quantify the relative risk of poor or excellent prognosis on both Activities of Daily Living (ADL) and mobility for each significant va riable. We prospectively studied 440 of 475 patients. From a group of 32 independent variables, these significantly associated with no, low and high effectiveness on both ADL and mobility were selected by means of multiple regression; then, the relative risk was calculated for ea ch variable that significantly entered the multiple regressions. Patie nts with severe impairment or with global aphasia showed a relative ri sk of no response 4-6 times higher than that of other patients. An int erval before rehabilitation longer than 2 months was associated with a n increasing risk of no response. Elderly patients had a significantly higher relative risk of low response both on ADL and mobility. The pr esence of hemineglect and depression was associated with an increasing risk of low response on ADL but not on mobility. The absence of hemin eglect and a short interval are prerequisites for an excellent functio nal prognosis on both ADL and mobility. A minor impairment, employed s tatus, the absence of global aphasia and age less than or equal to 65 years increased the risk of high response. At the beginning of treatme nt, clear prognostic factors for the detection of subgroups with poor or excellent rehabilitation prognosis can be identified.