Functional improvement for patients with stroke receiving postacute care rehabilitation program

Abstract

Background: Few studies explore the patient heterogeneity, trajectory development, and factors influencing the functional recovery of the postacute care cerebrovascular disease (PAC?CVD) program. The objective of the study was to analyze the group?based trajectory and different functional improvement for patients with acute stroke participating in the PAC?CVD program.

Materials and Methods: A total of 328 patients with acute stroke who had participated in PAC?CVD program in rehabilitation departments of three hospitals from 2014 to 2017 were enrolled in this retrospective cohort study. Latent profile analysis (LPA) was applied to analyze the clinical characteristics between high? and low?function groups (LFGs). The analysis of variance and Chi?square test were used to analyze the association between functional grouping and patients’ characteristics.

Results: In the study baseline, patients could be divided into high function group (HFG; 85/328 = 25.9%), medium function group (MFG; 128/328 = 39.02%), and (LFG; 115/328 = 35.06%) by LPA. age (P = 0.001), length of hospital stays (P = 0.001), male sex (P = 0.048), and lesion type (P = 0.023) were significantly associated with being grouped in the high?function group. After 6 weeks of rehabilitation training, 100% of HFG remained as HFG, 49.04% of MFG transitioned to HFG, and 50% of MFG continued to remain as MFG. 8.41% of LFG transitioned to HFG, 57% of LFG transitioned to MFG, but still, 34.58% of LFG continued to remain as LFG.

Conclusion: Identifying initial functional groups can guide medical professionals to target patients for PAC service use. PAC?CVD high?intensity rehabilitation significantly enhances acute stroke patients’ functional recovery, though effectiveness varies over time. These factors highlight the need for further development of rehabilitation programs to boost patient independence.