Prearranged goal of activity and length of stay of patients with stroke in the post acute rehabilitation unit

Abstract

The goal of activity (PGA) and length of stay (PLS) of 116 inpatients with stroke in the post acute rehabilitation unit were prearranged simultaneously with the first evaluation. The first FIM and SIAS (Stroke Impairment Assessment Set) were measured at 57.4±15.7 days after the onset and the last FIM was scaled just before the discharge. The PGA was also scored by FIM. The predicted FIM gain (PGA-first FIM) was correlated to the real FIM gain (R²=0.408) and the PLS was correlated to the real length of stay (RLS: 79.5±20.3 days) (R²=0.598). For further examination, patients were divided into four groups according to the goal error (GE: PGA-last FIM) and the length error (LE: RLS-PLS), as follows: Group AI, GE≤7 and LE≤13, 39 cases;Group AII, GE≤7 and LE≥14, 32 cases;Group BI, GE≥8 and LE≤13, 23 cases; and Group BII, GE≥8 and LE≥14, 22 cases. To investigate the factors affecting the errors, several clinical indicators were analyzed among the groups. Group AII had lower scores for the sum of the first FIM and SIAS but conserved cognitive function. Group BI had disturbed cognitive function in the first FIM and body function of SIAS. Group BII had extremely low scores for the first FIM and SIAS. The home return rates were significantly low in Groups BI and BII. In order to establish the PGA and PLS with accuracy, multiple factors affecting efficacy of rehabilitation should be considered in each patient.