Comparison of the Results of Early and Delayed Inpatient Stroke Rehabilitation

Objective: This study was designed to investigate the best time to start rehabilitation and to identify the predictors of functional outcomes after rehabilitation in patients with stroke after their first cerebrovascular accident. Materials and Methods: A total of 138 stroke patients who had their first stroke were divided into 5 groups according to the time elapsed from the cerebrovascular accident to the onset of rehabilitation (first 20 days, 21-40, 41-60, 61-80, and 81-100 days). Motor status of the patients was evaluated with the Brunnstrom Recovery Scale (BRS) and their functional status was assessed using the Functional Independence Measure (FIM) at admission and discharge. There was no statistically significant difference among the groups in terms of age, gender, localization of the lesion, etiology, and motor and functional status at baseline as well as additional systemic diseases. According to the results of rehabilitation, efficiency (average increase in FIM per day) and effectiveness (proportion of potential improvement achieved during rehabilitation of the groups) were calculated. Results: There was no statistically significant difference among the groups in terms of efficiency and effectiveness. Correlation analysis revealed that efficiency showed negative correlations with shoulder subluxation while efficiency showed a positive correlation with BRS scores of the lower extremities and effectiveness. However, effectiveness showed positive correlations with efficiency, baseline FIM scores, and BRS scores of the hands, arms, and the lower extremities while it was inversely correlated with shoulder subluxation and bladder incontinence. Conclusion: We concluded that starting stroke rehabilitation at any time within the first 100 days following the first stroke did not affect the results of rehabilitation. Therefore, we assume that starting stroke rehabilitation even after a delayed period also seems to be as efficacious as early rehabilitation. Turk J Phys Med Rehab 2013;59:7-12.