Prognostication in Stroke Rehabilitation
Good early prediction of ultimate outcome following stroke rehabilitation benefits patients and health care professionals. Numerous research studies have reported stroke outcomes, but the conclusions are not always in agreement because of differences in study methodology and in patient characteristics. However, some general conclusions about prognostication can be made. Early survival is poorer in those patients who have cerebral hemorrhage, coma at onset, or heart disease. Recovery from neurological impairment such as hemiplegia is influenced by lesion-related variables such as lesion size and location. Recovery from hemiplegia follows a predictable pattern, with most motor recovery occurring within the first 6 months. The disability status of stroke patients at late follow-up depends most on initial activities of daily living (ADL) scores recorded post onset. Characteristics that predict a less favorable outcome are older age and presence of urinary incontinence, bowel incontinence, and visuospatial deficits. Social and psychological variables, especially prestroke family interaction and presence of an able spouse, may strongly influence ultimate disability status and the return of patients to their home.
KeywordsFunctional Independence Measure Stroke Rehabilitation Motor Recovery Arch Phys Post Onset
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