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Predictors of physical independence at discharge after stroke rehabilitation in a Dutch population

The aim of this study was to identify predictors, available at admission, of
physical independence at discharge from inpatient rehabilitation. Secondary aims
were to identify predictors of functional gain and length of stay (LOS). We
included 1310 adult stroke patients who were admitted for inpatient
rehabilitation in five Dutch rehabilitation centres.
Data on the Utrecht Scale
for Evaluation of Clinical Rehabilitation at admission and discharge (physical
and cognitive independence, mood, pain and fatigue), age, sex and in a subsample
stroke characteristics as well were collected. A prediction model was created
using random coefficient analysis. None of the stroke characteristics were
independently associated with physical independence or functional gain at
discharge, or LOS. Higher physical and cognitive independence scores and severe
pain at admission were predictors of higher physical independence scores at
discharge. Furthermore, lower physical independence scores, higher cognitive
independence scores, less pain at admission and younger age predicted more
functional gain. Finally, lower physical and cognitive independence scores at
admission and younger age predicted longer LOS. Physical independence at
admission was the most robust predictor for rehabilitation outcome in a Dutch
rehabilitation setting. To a lesser extent, age, cognitive independence and pain
predicted rehabilitation outcome after stroke. Treatment of cognition and pain
should be taken into account during rehabilitation.
Further work needs to be
carried out to establish whether focusing on these factors improves outcome after
rehabilitation.
- Pays Bas

Langue : ANGLAIS

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