Factors Predicting Recovery of Motor Function in Stroke Patients in a Convalescent Rehabilitation Ward: From Acute Treatment to Recovery Phase Rehabilitation

Abstract

  An early start to rehabilitation is recommended to improve motor dysfunction caused by cerebrovascular diseases. However, an early start does not adequately restore motor function in all patients. We examined which factors affect the recovery of motor function by early rehabilitation. Our subjects were 149 inpatients with cerebral infarction (CI) and 108 with intracerebral hemorrhage (ICH) admitted to our hospital between 2016 and 2018. After acute treatment, they were admitted to the convalescent rehabilitation ward. The 257 patients were divided into 2 groups: those with good recovery of motor function and those with poor recovery. The criterion for grouping was set at a score of 30 or more (good) or less than 30 (poor) on the achievement index. We examined factors associated with rehabilitation in the 2 groups, including age, number of hospitalization days in the acute care ward, number of days in the rehabilitation ward, and motor and cognitive scores on the Functional Independence Measure (FIM) upon admission to the rehabilitation ward. Multivariate analysis was included in the statistical analysis. A total of 90 CI patients and 60 ICH patients had good recovery of motor function due to early rehabilitation. In the good recovery group of both CI and ICH patients, hospitalization durations during the acute phase were shorter and FIM cognitive scores were higher. Additionally, FIM motor scores were higher in ICH patients with good recovery. There were no significant differences in age or hospitalization days in the rehabilitation ward. According to multivariate analysis, FIM cognitive score was a factor that affected motor function recovery in both patients with CI (odds ratio, OR: 1.07, p ＜ 0.05) and in those with ICH (OR: 1.09, p ＜ 0.05). In conclusion, we found that, in stroke patients with CI or ICH, the factor best correlated with good recovery of motor function by early rehabilitation was a higher FIM cognitive score, rather than age or length of hospitalization.