Clinical Profile and Predictors of Motor Function Improvement at Discharge following Inpatient Stroke Rehabilitation in a Public Rehabilitation Hospital

Abstract

Background and Objectives: Data on the outcomes following inpatient stroke rehabilitation (ISR) in developing countries, including Malaysia, are scarce. This study aimed to assess the motor function outcomes among stroke patients following ISR in a rehabilitation hospital and identify the predictors affecting their motor function improvement. Methods: This retrospective observational study analysed data on stroke patients admitted to a rehabilitation hospital for ISR from January 2014 to December 2015. All patients received 60 minutes of physiotherapy sessions five times a week. Purposive sampling was used in this study. The Motor Assessment Scale (MAS) score was the primary outcome measure and assessed during admission and discharge. Linear regression analyses identified the predictors of MAS score improvement from the subjects’ demographics and clinical characteristics. Results:124 subjects were analysed with a mean age of 53.9 (SD=13.6) years, predominantly male (n=93, 75.0%), and the majority had an ischemic stroke (n=99, 79.8%). The median length of stay (LOS) was 30 (19.0–41.8) days. The majority of subjects had stroke onset to ISR admission interval (OAI) of <90days (n=77, 62.1%). Overall, the subjects’ achieved a median MAS score improvement of 9 points (p<0.001). An equation to predict the MAS score improvement following ISR was derived: MAS score improvement = 5.273 + 0.114(LOS)+ 4.269(OAI <90days). Conclusion: ISR was able to improve stroke patients’ motor function in our setting. The above-identified predictors can help guide ISR duration for stroke patients and highlight the importance of early enrolment into ISR before the late subacute stroke recovery phase.