Stratification of stroke rehabilitation: Five-year profiles of functional outcomes.
Bryan Ping Ho Chung
PMID 30930586WHAT IT FOUND
Stroke rehab patients admitted who needed help or supervision to walk showed the biggest daily mobility and self-care gains.
Those unable to sit, sitting but not walking, or already independent gained less per day. Admission walking level indicated likely discharge mobility.
Key findings
01Length of stay was longest for admission MFAC 1 and 2 (27.7 and 26.6 days) and shortest for admission MFAC 7 (6.1 days).
02Daily mobility gains were greatest in admission MFAC 3 to 5, and daily self-care gains were greatest in admission MFAC 4 and 5.
03At discharge, 12.7% of patients admitted as lyers (MFAC 1) and 58.2% of patients admitted as sitters (MFAC 2) progressed to any walking category.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
All records came from one Hong Kong rehabilitation hospital, so the pattern may not apply elsewhere. The study excluded patients who died, were transferred back to acute care, or left against advice, so it describes completed rehabilitation stays. It did not test whether changing therapy intensity based on admission walking level improves outcomes. The most independent admission groups were very small, so their discharge percentages are less stable.
Declared interests
The author declared no financial conflicts and reported no funding or grant support.
The easy way to misread this
Do not conclude that giving more therapy to patients who need help or supervision to walk will improve their outcomes. The study describes past records and did not test different therapy intensity.