Clinical scales for measuring stroke rehabilitation promote functional recovery by supporting teamwork.

BACKGROUND

The growing interest in documenting the effectiveness of rehabilitation has led to a progressive increasing focus on clinical tools to measure stroke-survivors disability and recovery. In clinical practice a general agreement on the instruments to be used seems to be lacking and clinical scales are often limited to the assessment of global function.

AIM

The study investigated whether the use of a selection of clinical scales/scores added to a single global measure during rehabilitation care, may lead to a better functional outcome for stroke inpatients.

DESIGN

Retrospective study.

SETTING

Neurorehabilitation inpatients.

POPULATION

Consecutive patients affected by first-ever stroke.

METHODS

Patients in the control group (CG) (N.=139) were assessed at admission and at discharge with the Functional Independence Measure (FIM), while patients in the study group (SG) (N.=127) were evaluated by means of a basic core-set of clinical scales/scores as well as with the FIM. Patients in both groups were evaluated and treated by the same multiprofessional team, following the same rehabilitative treatment approaches.

RESULTS

At discharge both groups significantly improved at the FIM total Score, compared to the admission; a significant improvement was also reported for all the clinical scales in SG. However, the CG showed longer length of stay (LOS) than the SG and between-group analysis revealed statistical significant differences in the FIM total score, in the FIM gain and in all the indices of performance (FIM efficiency, FIM absolute efficacy, FIM relative efficacy), in favor of the SG.

CONCLUSIONS

The use of a selection of scales added to a global functional measure, allows a better definition of both the person's profile of disability and the rehabilitative goals, and is associated to a better functional outcome at discharge.

CLINICAL REHABILITATION IMPACT

Clinical scales may be used in clinical practice to better define the person's profile of disability, allowing the design of patient tailored goals, and to favor team working.