Mobility status after inpatient stroke rehabilitation: 1-year follow-up and prognostic factors

Objectives: To evaluate the stability of mobility status achieved by stroke patients during hospital rehabilitation treatment over time and to identif y reliable prognostic factors associated with mobility changes. Design: Follow-up evaluation in consecutive first-ever stroke patients 1 ye ar after hospital discharge. Multiple logistic regressions were used to ana lyze increases and decreases in Rivermead Mobility Index (RMI) scores (depe ndent variables) between discharge and follow-up. Independent variables wer e medical, demographic, and social factors. Setting: Rehabilitation hospital. Patients: A cohort of 155 patients with sequelae of first stroke, with a fi nal sample of 141. Main Outcome Measures: Mobility status at 1-year followup, as measured by t he RMI, and odds ratios (OR) for improvement and decline in mobility. Results: Functionally, 19.9% improved the mobility levels achieved during t he inpatient rehabilitation treatment; levels of 42.6% worsened. Patients w ith global aphasia (OR = 5.66; 95% confidence interval [CI], 1.50-21.33), u nilateral neglect (OR = 3.01; 95% CI, 1.21-7.50), and age 75 years or older (OR = 5.77; 95% CI, 1.42-23.34) had a higher probability of mobility decli ne than the remaining patients. Postdischarge rehabilitation treatment (PDT ), received by 52.5% of the final sample, was significantly and positively associated with mobility improvement (OR = 5.86; 95% CI, 2.02-17.00). Absen ce of PDT was associated with a decline in mobility (OR = 3.73; 95% CI, 1.7 3-8.04). Conclusions: In most cases, mobility status had not yet stabilized at hospi tal discharge. PDT was useful in preventing a deterioration in mobility imp rovement achieved during inpatient treatment and in helping increase the li kelihood of further mobility improvement.