FUNCTIONAL STATUS OF CORTICAL AND SUBCORTICAL NONHEMORRHAGIC STROKE SURVIVORS AND THE EFFECT OF LESION LATERALITY

The purpose of this study is to examine the effects of cortical and su bcortical infarcts and lesion laterality on the functional status of s troke survivors. Medical records of 72 stroke survivors admitted to an acute inpatient rehabilitation facility with a single nonhemorrhagic lesion were retrospectively reviewed. Multivariate analysis of varianc e was used to assess the effects of lesion level and hemisphere on adm ission and discharge Functional Independence Measure (FIM(TM)) and FIM gain. Admission FIM-Total and its subdimensions exhibited significant overall level (Wilk's lambda = 2.5; P = 0.03) and hemisphere-specific (Wilk's lambda = 2.3; P = 0.04) effects. Significant interaction betw een factors was noted only for the communication subdimension. Signifi cant level and hemisphere-specific main effects were noted for admissi on FIM-Total (P < 0.01 and P = 0.02, respectively). There were signifi cant level-specific main effects for self-care (P = 0.01) and mobility (P = 0.03) and hemisphere and level-specific main effects for communi cation (P < 0.01 and P < 0.01,respectively) and social cognition (P = 0.02 and P = 0.01, respectively). Discharge FIM-Total and its subdimen sions exhibited significant overall level (Wilk's lambda = 2.5; P = 0. 03) and hemisphere-specific (Wilk's lambda = 3.4; P = 0.01) effects. D ischarge FIM subdimensions did not exhibit significant interaction bet ween factors. Discharge FIM-Total was significant with respect to lesi on level (P = 0.01) but not with respect to hemisphere (P = 0.08). The re was a significant level-specific main effect for self-care (P = 0.0 1) and level and hemisphere-specific main effects for communication (P < 0.01 and P < 0.01, respectively) and social cognition (P = 0.01 and P = 0.01, respectively). FIM gain scores did not exhibit significant level (Wilk's lambda = 1.1; P = 0.36) or hemisphere-specific (Wilk's l ambda = 1.4; P = 0.24) effects. The data suggest that the lesion level and hemisphere are important determinants of the function of nonhemor rhagic stroke survivors during inpatient rehabilitation.