Turkish Journal of Physical Medicine and Rehabilitation 2008 , Vol 54 , Num 3

Factors Associated with Functional and Cognitive Improvement in Patients with Stroke After Rehabilitatio

Bengi Öz 1 ,Berrin Koca 1 ,Neşe Ölmez 2 ,Asuman Memiş 2
1 Atatürk Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İzmir
2 Atatürk Eğitim ve Araştırma Hastanesi Fiziksel Tıp ve Rehabilitasyon Kliniği, İzmir

Objective: In this study, we evaluated the factors associated with the functional outcome in patients rehabilitated after stroke.

Materials and Methods: Thirty hemiplegic patient, admitted to an inpatient rehabilitation program, were recruited to the study. The functional status was evaluated by the Functional Independence Measure (FIM), ambulatory status by the Rivervead Mobility Index (RMI), motor impairment by the Brunnstrom 
stages, and cognitive impairment by the Mini-Mental Test (MMT) on admission and discharge. Multivariate analysis was used to assess the relationship between functional gain and the predictive variables.

Results: All outcome scores were increased significantly during rehabilitation. In the patient onset to admission interval of <40 days, the mean FIM gain was higher, while admision FIM scores were lower compared to late participants. FIM gain was correlated with mobility (RMI) and motor recovery (Brunnstrom stage) of lower extremities. Multiple linear regression analysis showed that the independent variables related to FIM gain were the FIM score on admission and motor improvement of lower extremities, but not the onset to admission interval. Cognitive improvement was found to be associated with upper extremity motor improvement, but not with functional gain evaluated by FIM.

Conclusion: Functional improvement was associated with motor improvement. Higher functional scores at admission had a lower functional gain due to the ceiling effect. Cognitive improvement may result in beter upper extremity motor function. 

Keywords : Acute stroke, functional gai