Article

There is a need for individuating those post-stroke
patients who may benefit from an optimal and customised rehabilitation plan
aiming at early reintegration in community life participation. This study
investigated whether the gain of independence in complex Activities of Daily
Living (ADL) may be predicted before the discharge from the stroke unit using
simple bedside determinants. METHODS: In 104 first-ever stroke patients with no
previous disability, ten determinants at 10 days after stroke were selected.
Multivariable logistic regression analysis was applied to identify the prognostic
determinants able to predict independence in complex ADL, as measured by modified
Rankin Scale grade </=2. RESULTS: The model shows that having a Barthel Index
>/=9, a Motricity Index- Upper Limb >/=75, an age </=70 and being a male resulted
in 100% probability of achieving independence in complex ADL. If three of the
four determinants were present, the probability was more than 90%. With the
presence of two of the four determinants, the probability ranged from 87% to 28%.
With the presence of only one determinant, the probability was 13%. CONCLUSIONS:
Accurate prediction of independence in complex ADL can be made before the
discharge from the stroke unit. The strength of the paretic upper limb, age,
gender, and the ability of performing basic ADL are the significant variables.
The probability of favorable prognosis depends on the presence and on the
robustness of each single determinant.

Langue : ANGLAIS