Significant differences in evaluation of disability and health (ICF) core sets between stroke rehabilitants and rehabilitation team during the first year.
Aet Ristmägi, Hannu Heikkila, Olavi Airaksinen
PMID 41649090WHAT IT FOUND
Stroke survivors rated their own abilities higher than their rehab team did, especially in thinking and daily tasks, at one month.
By one year, these views aligned more closely. Survivors saw little change in their own function, while the team recorded significant improvements.
Key findings
01At one month post-discharge, patients consistently rated their own restrictions as less severe than the rehabilitation team, with the largest gaps seen in cognitive domains like memory and problem-solving.
02By the 12-month follow-up, the overall disagreement between patient and team assessments had diminished, though patients still rated some functions like fine motor hand use as worse than the team did.
03The rehabilitation team identified statistically significant improvements in 18 subdomains over the first year, while patients reported no significant change in most motor or self-care areas.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was single-centre and retrospective, which limits generalizability and introduces potential reporting bias. The population was selected for optimal rehabilitation potential, so results may not apply to more severely affected or non-rehabilitated patients. Seventeen patients were excluded from ICF analysis due to cognitive or linguistic barriers, meaning the findings do not represent those with severe aphasia or dementia. The 'team' assessment was a composite of multiple disciplines, so it is unclear how much individual clinician bias influenced the ratings.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the patient's high self-ratings at 1 month as evidence of rapid recovery or good insight. This study suggests that early patient confidence often exceeds objective capability, particularly in cognitive and self-care tasks, and may reflect a coping mechanism or lack of awareness rather than true functional independence.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →