Article

The aim of the study was to assess early poststroke prognostic factors
in patients admitted for postacute phase rehabilitation. METHODS: A 1-yr
multicenter prospective project was conducted in four Italian regions on 352
patients who were hospitalized after a first stroke and were eligible for
postacute rehabilitation.
Clinical data were collected in the stroke or acute
care units (acute phase), then in rehabilitation units (postacute phase), and,
subsequently, after a 6-mo poststroke period (follow-up). Clinical outcome
measures were represented using the Barthel Index and the modified Rankin Scale.
Univariate and multivariate analyses were performed to identify the most
important prognostic index. RESULTS: Modified Rankin Scale score, minor
neurologic impairment, and early out-of-bed mobilization (within 2 days after the
stroke) proved to be important factors related to a better recovery according to
Barthel Index (power of prediction = 37%). Similarly, age, premorbid modified
Rankin Scale score, and early out-of-bed mobilization were seen to be significant
factors in achieving better overall participation and activity according to the
modified Rankin Scale (power of prediction = 48%). Barthel Index at admission and
certain co-morbidities were also significant prognostic factors correlated with a
better outcome. CONCLUSIONS: According to the Barthel Index and modified Rankin
Scale, early mobilization is an early predictor of favorable outcome. TO CLAIM
CME CREDITS: Complete the self-assessment activity and evaluation online at
http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this
article, the reader should be able to: (1) Incorporate prognostic factors of good
clinical outcomes after stroke in developing treatment plans for patients
admitted to rehabilitation; (2) Identify acute phase indicators associated with
favorable 6-mo outcome after stroke; and (3) Recognize the cut-off for early
mobilization linked to better outcome in stroke survivors admitted to
rehabilitation. LEVEL: Advanced ACCREDITATION: The Association of Academic
Physiatrists is accredited by the Accreditation Council for Continuing Medical
Education to provide continuing medical education for physicians.The Association
of Academic Physiatrists designates this Journal-based CME activity for a maximum
of 1.0 AMA PRA Category 1 Credit(s). Physicians should only claim credit
commensurate with the extent of their participation in the activity.

Langue : ANGLAIS