Functional measures upon admission to acute inpatient rehabilitation predicts quality of life after ischemic stroke

Publication date: Available online 4 July 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Chen Lin, Mansi Katkar, Jungwha Lee, Elliot Roth, Richard L. Harvey, Shyam Prabhakaran

Abstract

Objective

To evaluate the association between functional measures at admission to acute inpatient rehabilitation (AIR) and HRQOL scores at 3 months after ischemic stroke.

Design

Consecutive patients with ischemic stroke admitted to AIR were consented to a prospective registry.

Setting

Large academic referral inpatient rehabilitation hospital

Participants

One-hundred thirteen patients with ischemic stroke

Interventions

NA

Main Outcome Measures

Admission Functional Independence Measure (FIM) and Berg Balance Scores (BBS) were abstracted when available. The Neuro-QOL questionnaire was used to assess 3-month HRQOL in 4 domains: upper extremity (UE), lower extremity (LE), executive functions (EF), and general concerns (GC). Associations of FIM and BBS scores with impaired HRQOL at 3 months were evaluated.

Results

One-hundred thirteen patients (mean age 70.6 ± 14.5 years; 54.0% male; 56.6% Caucasian) were included in the analysis. The median time from stroke onset to admission FIM and BBS was 6.4 (IQR 4.2-11.3) and 8.9 (IQR 5.8-14.4) days, respectively. A 5-point increase in admission FIM score decreased the likelihood of impairment in HRQOL at 3 months by 25% for GC (OR 0.75, 95% CI 0.61-0.93, p=0.01), 31% for EF (OR 0.69, 95% CI 0.56-0.85, p=0.001), 16% for UE function (OR 0.84, 95% CI 0.73-0.96, p=0.01), and 21% for LE function (OR 0.79, 95% CI 0.67-0.93 p=0.004). A 5-point increase in admission BBS decreased the likelihood of impairment in HRQOL domains at 3 months by 15% for UE function (OR 0.85, 95% CI 0.75-0.98, p=0.02) and 25% for LE function (OR 0.75, 95% CI 0.64-0.89, p=0.001).

Conclusions

Admission FIM and BBS were strongly associated with 3-month HRQOL associated across multiple domains following stroke. These findings indicate that HRQOL can be predicted earlier in a patient's course during AIR.

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