Functional Outcomes of A 3-month Stroke Rehabilitation Program Conducted Following the Intermediate Care (IMC) Service Plan

Kanta Suwanchai; Rachawan Suksathien

Authors

Kanta Suwanchai Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima
Rachawan Suksathien Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima

Keywords:

stroke, rehabilitation, functional outcome, intermediate care (IMC)

Abstract

Objectives: To study the functional outcomes of stroke patients receiving a 3-month rehabilitation program in an intermediate care (IMC) service plan and the association between recommended training sessions and good functional outcomes

Study design: Prospective observational study

Setting: The Stroke Unit and Outpatient Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital (MNRH), Thailand

Subjects: Sixty-two patients with moderate stroke (NIHSS 5-15) who were admitted at MNRH between September 2022 and July 2023 and who were enrolled in IMC.

Methods: Patients’ demographics, stroke information, rehabilitation program (physical therapy [PT] and occupational therapy [OT]), and locations of service were collected. Barthel index (BI) score on the day of IMC enrollment and at 2 weeks and 3 months were evaluated. In this study a BI ≥ 75 indicates a good functional outcome. Variables with statistically significant differences between the good and poor functional outcome groups were included in a multiple logistic regression analysis to examine the association between the number of training sessions and good functional outcomes.

Results: The mean age of the patients was 61 years (SD 9.3). 79.0% of the patients achieved good functional outcomes at 3 months after enrollment in IMC. There were 6 locations where patients received rehabilitation services following discharge from the hospital. The median total number of PT and OT sessions with interquartile ranges were 8 (4,13) and 1 (0,1). The mean and standard deviation of BI improvement was 45.6 (28.4) with a p-value < 0.01. 44.0% and 11.0% of patients received the PT program ≥ 10 sessions and the OT program ≥ 3 sessions as specified in the IMC guideline. In the multivariable analysis, the adjusted odds ratio of PT sessions ≥ 10 and OT sessions ≥ 3 and good functional outcomes were 4.58 (95%CI: 0.43, 48.70, p = 0.207) and 2.62 (95%CI: 0.09, 70.52, p = 0.565), respectively.

Conclusions: Stroke patients in the IMC service plan had significant BI improvement. A total of 44.0% and 11.0% of patients, respectively, received the recommended PT and OT training sessions following IMC guidelines. Although the number of PT and OT training sessions was not statistically significantly associated with the outcomes, the IMC service improved the clinical outcome of stroke patients and showed benefits in clinical practice.

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