Early versus delayed inpatient stroke rehabilitation: A matched comparison conducted in Italy

Stefano Paolucci, Gabriella Antonucci, Maria Grazia Grasso, Daniela Morelli, Elio Troisi, Paola Cairo, Maura Bragoni

Research output: Contribution to journalArticle

Abstract

Objective: To assess the specific influence of onset-admission interval (OAI) on rehabilitation results. Design: A case-control study in consecutive stroke inpatients, enrolled in homogeneous subgroups, matched for age (within 1 year) and Barthel Index (BI) score at admission, and different for OAI to the rehabilitation ward. The short OAI group began rehabilitation treatment within the first 20 days from stroke, medium OAI group between days 21 and 40, and long OAI between days 41 and 60. Setting: Rehabilitation hospital. Patients: One hundred forty-five patients with sequelae of first stroke. Main Outcome Measures: Efficiency (average increase in BI per day), effectiveness (proportion of potential improvement achieved during rehabilitation) of treatment, and percentage of low- and high-response patients, calculated on BI, were evaluated. Odds ratios (ORs) of dropouts and of poor and excellent therapeutic response were also quantified. Results: The short OAI subgroup had significantly higher effectiveness of treatment than did the medium (p <.05) and the long OAI groups (p <.005). Beginning treatment within the first 20 days was associated with a significantly high probability of excellent therapeutic response (OR = 6.11; 95% confidence interval [CI], 2.03-18.36), and beginning later was associated with a similar risk of poor response (OR = 5.18; 95% CI, 1.07-25.00). On the other hand, early intervention was associated with a five times greater risk of dropout than that of patients with delayed start of treatment (OR = 4.99; 95% CI, 1.38-18.03). The three subgroups were significantly (p <.05) different regarding the percentage of low and high responders. Conclusion: Our results showed a strong association between OAI and functional outcome. (C) 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

Original languageEnglish
Pages (from-to)695-700
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume81
Issue number6
DOIs
Publication statusPublished - Jun 2000

Keywords

  • Italy
  • Rehabilitation
  • Stroke
  • Treatment outcome

ASJC Scopus subject areas

  • Rehabilitation

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