Rehabilitation After Stroke in a Transition From Hospital to Municipality—Impact of Amount of Rehabilitation
Gabriel Tafdrup Notkin, Dorthe Gaby Bove, Lisbet Lind, Michael Broksgaard Jensen, Stig MolstedABSTRACT
Background
Stroke is a leading cause of long‐term disability that impairs physical function and health‐related quality of life (HRQoL). Rehabilitation during and after hospitalization is essential for promoting neurological recovery and functional independence. This study aims to investigate (1) changes in physical function, balance, and HRQoL from hospital admission to completion of rehabilitation after stroke; (2) associations between rehabilitation amount and changes in physical function and balance; and (3) patient outcomes after rehabilitation compared with those of the general population.
Methods
Patients with stroke scheduled for rehabilitation were enrolled in this cohort study. Outcomes assessed at admission, discharge, and the beginning and end of outpatient rehabilitation included the 30‐s Chair Stand Test (30sCST) and Berg Balance Scale (BBS). EQ‐5D‐5L data were collected at admission and after rehabilitation. Rehabilitation hours were recorded and included in the analyses.
Results
A total of 121 patients were included (age 72 ± 10 years; 35.5% female). Performance on the 30sCST and BBS and EQ‐5D‐5L visual analog scale scores improved throughout the study (30sCST: 1.63 [0.96; 2.30]–10.76 [9.47; 12.04] repetitions; p < 0.001). The EQ‐5D‐5L index remained unchanged. The number of rehabilitation sessions was not associated with changes in 30sCST or BBS scores. After rehabilitation, patients continued to have lower 30sCST performance and EQ‐5D‐5L scores than the general population (30sCST: 11.9 [10.7; 13.2] vs. 16.9 [16.1; 17.7] repetitions, respectively; p < 0.001).
Conclusions
Physical function, balance, and HRQoL improved during inpatient and outpatient rehabilitation. However, rehabilitation sessions were not associated with improvements in physical function or balance. Compared with the general population, patients continued to have reduced physical function and HRQoL after rehabilitation, suggesting a need for continued self‐managed rehabilitation.