S-2-04-01
ON MEASUREMENT OF OUTCOME IN STROKE REHABILITATION
Axel R. Fugl-Meyer (Department of Rehabilitation Medicine, Uppsala University, Uppsala, Sweden)
The outcome of stroke rehabilitation may be measured at three different levels:
* The final level of functions. Such measures are assessments of joint motion, motor-control, perceptual function, cognitive, linguistic and motor-praxis functions. Many of these measurements are, however, difficult to use in rehabilitation practice because interventions most often are implemented during the natural course of restitution after the stroke.
* The final level of capacity to act - a level that is generally termed ability. When measuring this level findings can usually not be generalized, because each person's activity repertoires are personal properties of his. People have abilities within ADL (personal as well as instrumental), leisure and work. In measuring abilities it is important to assess the impact of each ability for the perceived roles of the rehabilitee.
* The final level, or change, in quality of life; which, again, can be measured in objective terms or, and in my opinion much better, subjectively, i.e. as the rehabilitee assesses his overall and domain-specific satisfaction with life.
In this presentation the different levels of assessment will be briefly surveyed and examplified. Their pros and cons will, to some extent, be dissected.
S-2-04-02
HAEMORRHAGIC STROKE VS ISCHAEMIC STROKE: LENGTH OF STAY AND FUNCTIONAL OUTCOME MEASURE IN STROKE SURVIVORS
Leonard S.W Li-1, Y.M. Fong-1, K.P. Leung-1, T.F. Cheung-2, S.L Ho-2 (1-Tung Wah Hospital and 2-Queen Mary Hospital, The University of Hong Kong, Hong Kong)
Purpose: This study evaluated the difference in functional outcome and duration of stay for inpatient rehabilitation between the haemorrhagic and ischaemic stroke.
Method: A prospective study was performed from the Tung Wah Stroke Rehabilitation Databank. Stroke types were defined by clinical assessment and CT scan. Functional outcome was measured by modified Barthel Index Length of stay was defined by hospitalisation days in the stroke rehabilitation unit.
Result: Among the 239 stroke patients admitted, 187(78.2%) were ischaemic and 52(21.8%) were haemorrhagic with no significant difference in age and sex . The co-morbidities including hypertension, diabetes mellitus, ischaemic heart disease and previous stroke also had no significant difference . The incidence of complications including fall, pressure sore, aspiration pneumonia, urinary tract infection and acute gastrointestinal bleeding during the period of rehabilitation were also similar in both groups An average length of stay in the rehabilitation unit was 40.9±23.4 days for the haemorrhagic group and 38.1±22.9 days for the ischaemic group (p=0.79) The functional score on admission was 41.1±15.7 and 55.0±19.9 in the haemorrhagic and ischaemic groups respectively. The functional score on discharge was 81.5±9.4 and 87.7±11.6 in the haemorrhagic and ischaemic groups respectively (p=0.90).
Conclusion: There were no significant difference in length of stay and functional outcome between the haemorrhagic and ischaemic stroke patients.
