Abstract
Objective
To evaluate the association between functional measures at admission to acute inpatient
rehabilitation (AIR) and health-related quality of life (HRQOL) scores at 3 months
after ischemic stroke.
Design
Consecutive patients with ischemic stroke admitted to AIR were consented to a prospective
registry.
Setting
Large academic referral inpatient rehabilitation hospital.
Participants
Patients (N=113) with ischemic stroke (mean age 70.6 ± 14.5y; 54.0% male; 56.6% white)
were included in the analysis.
Interventions
Not applicable.
Main Outcome Measures
Admission FIM and Berg Balance Scores (BBS) were abstracted when available. The Neuro-Quality
of Life questionnaire was used to assess 3-month HRQOL in 4 domains: upper extremity
(UE), lower extremity (LE), executive functions (EF), and general concerns (GC). Associations
of FIM and BBS scores with impaired HRQOL at 3 months were evaluated.
Results
The median time from stroke onset to admission FIM and BBS was 6.4 (interquartile
range [IQR] 4.2-11.3) and 8.9 (IQR 5.8-14.4) days, respectively. A 5-point increase
in admission FIM score decreased the likelihood of impairment in HRQOL at 3 months
by 25% for GC (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.61-0.93, P=.01), 31% for EF (OR 0.69, 95% CI 0.56-0.85, P=.001), 16% for UE function (OR 0.84, 95% CI 0.73-0.96, P=.01), and 21% for LE function (OR 0.79, 95% CI 0.67-0.93 P=.004). A 5-point increase in admission BBS decreased the likelihood of impairment
in HRQOL domains at 3 months by 15% for UE function (OR 0.85, 95% CI 0.75-0.98, P=.02) and 25% for LE function (OR 0.75, 95% CI 0.64-0.89, P=.001).
Conclusions
Admission FIM and BBS were strongly associated with 3-month HRQOL associated across
multiple domains following stroke. These findings indicate that HRQOL can be predicted
earlier in a patient’s course during AIR.
Keywords
List of abbreviations:
AIR (acute inpatient rehabilitation), BBS (Berg Balance Score), CI (confidence interval), EF (executive functions), GC (general concerns), LE (lower extremity), mRS (modified Rankin Scale), NIHSS (National Institutes of Health Stroke Scale), HRQOL (health-related quality of life), IQR (interquartile range), Neuro-QOL (Neuro-Quality of Life), OR (odds ratio), QOL (quality of life), TOAST (Trial of Org 10172 in Acute Stroke Treatment), UE (upper extremity)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 03, 2018
Footnotes
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
