Turkish Journal of Physical Medicine and Rehabilitation 2016 , Vol 62 , Num 3

Functional recovery in stroke patients with and without diabetes mellitus

Nurdan Paker 1 ,Derya Buğdaycı 1 ,Berna Çelik 1 ,Feride Sabırlı 1 ,Ayşe Nur Bardak 1
1 Department of Physical Medicine and Rehabilitation, İstanbul Training and Research Hospital Physical Therapy and Rehabilitation, İstanbul, Turkey DOI : 10.5606/tftrd.2016.33682 Objectives: This study aims to compare the outcomes of the functional recovery in diabetic and non-diabetic patients with stroke in an inpatient rehabilitation setting.

Patients and methods: A total of 118 patients (43 males, 75 females; mean age 63.9±10.7 years; range 30 to 83 years) with stroke were included in this prospective study between January 2010 and December 2013. The patients were divided into two groups: diabetics (n=46) and non-diabetics (n=72). Demographic data, duration of stroke, etiology and blood glucose levels of all study population were recorded. Functional status was evaluated with the Functional Independence Measurement (FIM) on admission and at discharge. The Mini-Mental State Examination (MMSE) scale was used for the initial assessment of the cognitive status. The Hospital Anxiety and Depression Scale (HADS) was used for the evaluation of mood. All patients were rehabilitated using the Bobath method in combination with proprioceptive neuromuscular facilitation (PNF) techniques.

Results: The mean stroke duration was 5.7±2.45 and 5.6±2.48 months in the non-diabetic and diabetic groups, respectively (p>0.05). The mean FIM scores on admission were 41.5±14.17 and 42.3±16.81 in the non-diabetic and diabetic groups, respectively (p>0.05). The mean length of stay was 25.2±8.72 and 24.7±8.94 days in the non-diabetic and diabetic groups, respectively (p>0.05). No statistically significant difference in the motor FIM, HADS anxiety and depression, and MMSE scores was found on admission between the groups (p>0.05). There was a statistically significant improvement in the motor FIM scores in both groups at discharge (p<0.05). The increase in the motor FIM scores after rehabilitation in the non-diabetic group was statistically significantly higher compared to the diabetic patients (p<0.01).

Conclusion: Our study results showed a significant functional improvement in both diabetic and non-diabetic patients with stroke at discharge. However, the increase in the functional independence level was higher in the non-diabetics. Keywords : Diabetes mellitus; functional independence; rehabilitation; stroke