gms | German Medical Science

Background: About 50% of all stroke survivors in the UK remain severely impaired with their functional abilities, even though, 22% survive a severe stroke. The evidence on functional gains following rehabilitation in severe stroke survivors is unclear due to a perceived reduced potential to improve. Although improvement in overall functional status has been reported there is still a dearth of research providing objective, temporal data on functional recovery after a severe stroke.

Aim: To measure changes in functional abilities and describe rehabilitation services received in the first six months post-stroke in a cohort of stroke survivors with severe disabilities.

Method: Patient outcomes were longitudinally measured over the first six months post-stroke in severe stroke survivors (NIHSS score >10, MRS >4 at admission) using a prospective observational study design. Data collected using standardized tools were statistically analysed. Rehabilitation provided during this period was recorded.

Results/findings: Function measured by the UK-FIM/FAM changed significantly (p≤.0001) from baseline to six months with a mean 46.55 (±31.43) points gained during the acute hospital stay that continued to improve in the community. 69% patients with severe disabilities had a clinically meaningful improvement in their functional abilities which did not have any causal relationship with initial severity. There was a noticeable involvement of health care professionals in the early days in the hospital and community.

Discussion and conclusions: The findings suggest that a significant functional improvement is possible in the severely disabled stroke patients. This is valuable in guiding the effective use of rehabilitation resources and designing future care for severe stroke survivors.