Influence of admission functional status on functional change after strokerehabilitation

Objective: To determine whether the admission functional score influences t he functional change after stroke rehabilitation. Design: Two hundred forty-three patients who had received the Functional In dependence Measure (FIM(TM)) assessment at admission and at discharge were enrolled in the study. The patients were stratified into three groups accor ding to their FIM total scores at admission, i.e., less than or equal to 36 , 37 to 72, and greater than or equal to 73. Results: The Scheffe's multiple comparison test showed that patients with F IM total scores of greater than or equal to 73 at admission were significan tly younger (58 +/- 11 [SD] yr) than those who had scores of 37 to 72 (64 /- 11 yr) or less than or equal to 36 (66 +/- 12 yr). Patients with FIM tot al scores of 37 to 72 at admission showed significantly higher FIM gain (37 +/- 15) compared with those patients who had scores of greater than or equ al to 73 (20 +/- 10) or less than or equal to 36 (29 +/- 23). Conclusion: The functional levels of affected patients at admission stratif ied by the FIM scale roughly predict the degree of functional gain after re habilitation in survivors with a first episode of ischemic stroke. Moderate ly affected patients will benefit from intensive rehabilitation. These find ings may be useful for rehabilitation triage.