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  4. Predictors of Gains During Inpatient Rehabilitation in Patients with Stroke– A Review

Predictors of Gains During Inpatient Rehabilitation in Patients with Stroke– A Review

Crit Rev Phys Rehabil Med, 2013 · DOI: 10.1615/CritRevPhysRehabilMed.2013008120 · Published: January 1, 2013

NeurorehabilitationRehabilitationResearch Methodology & Design

Simple Explanation

Stroke is a major cause of disability, and stroke rehabilitation is costly. Identifying factors that predict response to inpatient stroke rehabilitation can help personalize therapy and maximize resource efficiency. This review of literature reveals that factors such as age, stroke subtype, nutritional status, and psychosocial factors (living with family or caregiver presence) significantly impact outcome after inpatient stroke rehabilitation. Functional status on admission, urinary incontinence, post-stroke infection, and aphasia can also affect prognosis. The strengths and weaknesses of the studies are considered to inform future research on predictors of inpatient rehabilitation response after stroke.

Study Duration
Not specified
Participants
Not specified
Evidence Level
Review

Key Findings

  • 1
    Younger age is consistently associated with better outcomes after stroke rehabilitation.
  • 2
    Patients with hemorrhagic stroke often have greater disability on admission but demonstrate greater gains during rehabilitation compared to those with ischemic stroke.
  • 3
    Factors like living with family or having a caregiver significantly increase the likelihood of being discharged home after inpatient rehabilitation.

Research Summary

This review summarizes key predictors of post-stroke rehabilitation outcomes, highlighting the strengths and weaknesses of many studies to provide recommendations for providers of post-stroke rehabilitation care. The review emphasizes the importance of modifiable risk factors like nutritional status and certain health conditions, alongside non-modifiable factors that may influence discharge planning. Further research is recommended through prospective, randomized controlled studies to ascertain the relationship of various factors in predicting positive gains during inpatient rehabilitation for stroke patients.

Practical Implications

Personalized Treatment Plans

Understanding predictive factors allows for the creation of personalized treatment plans tailored to individual patient needs, optimizing rehabilitation outcomes.

Resource Allocation

Identifying patients likely to have poorer outcomes can aid in appropriate resource allocation and discharge planning, ensuring adequate support systems are in place.

Targeted Interventions

Addressing modifiable risk factors such as malnutrition, infections, and psychosocial issues can improve patient prognosis during and after inpatient rehabilitation.

Study Limitations

  • 1
    Retrospective study designs in some included studies
  • 2
    Potential bias due to reliance on specific databases (e.g., UDSMR)
  • 3
    Subjective nature of some assessment tools (e.g., SGA for malnutrition)

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