Impact of Recurrence on Functional Independence in Stroke Patients Treated in a Convalescent Rehabilitation Hospital

Yoshihiro Kanata; Yuki Uchiyama; Saya Iwasa; Satoko Matsushima; Yuta Tauchi; Tetsuo Koyama; Kazuhisa Domen

doi:10.7759/cureus.72658

Impact of Recurrence on Functional Independence in Stroke Patients Treated in a Convalescent Rehabilitation Hospital

Cureus. 2024 Oct 29;16(10):e72658. doi: 10.7759/cureus.72658. eCollection 2024 Oct.

Authors

Yoshihiro Kanata^{1

2}, Yuki Uchiyama³, Saya Iwasa², Satoko Matsushima², Yuta Tauchi², Tetsuo Koyama⁴, Kazuhisa Domen³

Affiliations

¹ Department of General Medicine and Community Health, Hyogo Medical University Sasayama Medical Center, Tanbasasayama, JPN.
² Department of Rehabilitation Medicine, Hyogo Medical University Sasayama Medical Center, Tanbasasayama, JPN.
³ Department of Rehabilitation Medicine, Hyogo Medical University, Nishinomiya, JPN.
⁴ Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, JPN.

Abstract

Purpose: Outcome prediction is a crucial component of rehabilitation in post-stroke patients. However, only a few studies have focused on the influence of stroke recurrence on outcomes in these patients. This study aimed to determine the impact of stroke recurrence on functional independence using data from a convalescent rehabilitation hospital.

Materials and methods: The study included stroke patients who were admitted to our convalescent rehabilitation hospital. Data were collected on age, stroke recurrence, and number of days between stroke onset and transfer to our facility. Scores for the motor component of the functional independence measure (FIM-motor) and stroke impairment assessment set (SIAS-motor) were obtained at admission and discharge. Multivariate regression analysis was performed using the FIM-motor score at discharge as the dependent variable. Stroke recurrence was used as the independent variable, with age, days from onset to transfer, and FIM-motor and total SIAS-motor scores at admission entered as covariates. To explore the impact of the size of deep white matter lesions from prior strokes, we used the Fazekas scale to classify the recurrent cases into subgroups (0-1 or 2-3) and compared the FIM-motor scores at discharge between them.

Results: After adjusting for the above-mentioned covariates, stroke recurrence emerged as a statistically significant predictor of a reduced FIM-motor score at discharge. Furthermore, in patients with recurrent stroke, those with larger deep white matter lesions had a significantly lower FIM-motor score at discharge.

Conclusions: Stroke recurrence was found to be an independent predictor of a reduced FIM-motor score. Moreover, in patients with recurrent stroke, larger deep white matter lesions were associated with further reductions in the FIM-motor score. These findings underscore the negative impact of recurrent stroke on functional independence in stroke patients.

Keywords: fazekas scale; functional independent measure (fim); recurrent strokes; rehabilitation; stroke outcome.

Grants and funding

This work was supported in part by a grant-in-aid for scientific research (C) from the Japan society for the promotion of science (JSPS KAKENHI) with a grant number JP22K11356.