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Influence of Admission Functional Status on Functional Change After Stroke Rehabilitation

Inouye, Masayuki MD, DMSci; Hashimoto, Hidetoshi MD; Mio, Takaya MS; Sumino, Kimiaki MD, DMSci

American Journal of Physical Medicine & Rehabilitation: February 2001 - Volume 80 - Issue 2 - p 121-125
CME Article•2001 Series•Number 2
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Inouye M, Hashimoto H, Mio T, Sumino K: Influence of admission functional status on functional change after stroke rehabilitation. Am J Phys Med Rehabil 2001; 80:121–125.

Objective To determine whether the admission functional score influences the functional change after stroke rehabilitation.

Design Two hundred forty-three patients who had received the Functional Independence Measure (FIMTM) assessment at admission and at discharge were enrolled in the study. The patients were stratified into three groups according to their FIM total scores at admission, i.e., ≦36, 37 to 72, and ≧73.

Results The Scheffé’s multiple comparison test showed that patients with FIM total scores of ≧73 at admission were significantly younger (58 ± 11 [SD] yr) than those who had scores of 37 to 72 (64 ± 11 yr) or ≦36 (66 ± 12 yr). Patients with FIM total scores of 37 to 72 at admission showed significantly higher FIM gain (37 ± 15) compared with those patients who had scores of ≧73 (20 ± 10) or ≦36 (29 ± 23).

Conclusion The functional levels of affected patients at admission stratified by the FIM scale roughly predict the degree of functional gain after rehabilitation in survivors with a first episode of ischemic stroke. Moderately affected patients will benefit from intensive rehabilitation. These findings may be useful for rehabilitation triage.

From the Department of Internal Medicine (MI), Hyogo Rehabilitation Center Hospital; and the Department of Public Health (HH, TM, KS), Kobe University School of Medicine, Kobe, Japan.

All correspondence and requests for reprints should be addressed to Masayuki Inouye, MD, Department of Internal Medicine, Hyogo Rehabilitation Center Hospital, Akebono-cho,1070, Nishi-ku, Kobe 651-2181, Japan.

FIMTM is a trademark of the Uniform Data System for Medical Rehabilitation, a division of U B Foundation Activities, Inc.

Objectives: Upon completion of this article, the reader should be able to: (1) recognize from the data that moderately affected patients at admission showed higher functional gain; (2) understand that mildly affected patients at admission were significantly younger; (3) discuss how rehabilitation triage would be helpful.

Level: Advanced.

The Association of Academic Physiatrists designates this continuing medical education activity for a maximum of one credit hour in Category 1 of Physician’s Recognition Award of the American Medical Association. Each physician should claim only those hours of credit that he/she actually spent in the education activity.

Disclosure: Disclosure statements have been obtained regarding the authors’ relationships with financial supporters of this activity. There is no apparent conflict of interest related to the context of participation of the authors of this article.

How to Obtain CME Category 1 Credits

To obtain CME Category 1 credit, this educational activity must be completed and postmarked by December 31, 2001. Participants may read the articles and take the exams issue by issue or wait to study several issues together. After reading the three CME Articles in this issue, participants may complete the Self-Assessment Exam by answering the questions on the CME Answering Sheet and the Evaluation pages, which appear later in this section. Send the completed forms to: CME Department, Association of Academics Physiatrists, 5987 E. 71st Street, Suite 112, Indianapolis, In 46220. Documentation can be received at the AAP National Office at any time throughout the year, and accurate records will be maintained for each participant. CME certificates are issued only once a year in January for the total number of credits earned during the prior year.

© 2001 Lippincott Williams & Wilkins, Inc.