Abstract
The purpose of this study is to predict the outcome (final independence level) in stroke rehabilitation early with a simple clinical method.
Our subjects consisted of 406 acute stroke patients who were admitted to a community hospital within one month after the onset. There average age was 67.0 years.
We used a combination of three factors to predict the final independence level of each patient. These factors were (1) patient's age, (2) independence levels on admission, two weeks after admission, one month after that and (3) clinical signs. We classified independence level into three: ambulant (AMB), independent in sitting (SIT), totally dependent (DEP). We divided clinical signs into motor disturbance and other 12 signs such as consciousness disturbance, dementia, night delirium, aphasia, left hemispatial agnosia.
Main results were as follows:
(1) Patients who were SIT on admission finally became AMB.
(2) Patients who were DEP on admission but had mild hemiparesis of Brunnstrom's recovery stage IV to VI finally became AMB.
(3) Patients who were DEP on admission but became SIT within one month after that finally became AMB.
(4) Among the patients who remained DEP one month after admission, certain patients continued to be DEP, who were 60 years or older and had delayed consciousness disturbance, dementia, bilateral hemiplegia or severe heart disease.
Based on these results, we composed a set of criteria for the early prediction, which could definitely predict the final independence level in 70% of the stroke cases on admission, in 80% two weeks after admission and in 90% one month after admission.
