Article

OBJECTIVE: To describe racial differences in patient characteristics, nontherapy
ancillaries, physical therapy (PT), occupational therapy (OT), and functional
outcomes at discharge in stroke rehabilitation. DESIGN: Multicenter prospective
observational cohort study of poststroke rehabilitation. SETTING: Six U.S.
inpatient rehabilitation facilities. PARTICIPANTS: Black and white patients
(n=732), subdivided in case-mix subgroups (CMGs): CMGs 104 to 107 for moderate
strokes (n=397), and CMGs 108 to 114 for severe strokes (n= 335). INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURE: FIM. RESULTS: Significant black-white
differences in multiple patient characteristics and intensity of rehabilitation
care were identified. White subjects took longer from stroke onset to
rehabilitation admission and were more ambulatory prior to stroke. Black subjects
had more diabetes. For patients with moderate stroke, black subjects were
younger, were more likely to be women, and had more hypertension and obesity with
body mass index greater than or equal to 30. For patients with severe stroke,
black subjects were less sick and had higher admission FIM scores. White subjects
received more minutes a day of OT, although black subjects had significantly
longer median PT and OT session duration. No black-white differences in
unadjusted stroke rehabilitation outcomes were found. CONCLUSIONS: Reasons for
differences in rehabilitation care between black and white subjects should be
investigated to understand clinicians' choice of treatments by race. However, we
did not find black-white differences in unadjusted stroke rehabilitation
outcomes.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS