Functional outcome at hospital discharge following first-time stroke

Abstract

Stroke is one of the common causes of prolonged disability and patients are often discharged early from hospital prior to achieving functional  independence. This study aimed to determine the functional outcomes in mobility and activities of daily living (ADLs) of first-time stroke survivors upon discharge from an acute inpatient hospital setting. Based on an observational cross-sectional design, stroke survivors (men: n = 35; women: n = 25) admitted to an acute care public hospital in Tshwane, South Africa, underwent mobility and ADLs assessment using the Modified Rivermead Mobility Index (MRMI) and the Barthel Index (BI), respectively upon discharge. Sixty stroke survivors (mean age: 47.5 ± 12.14 years) participated in the study; majority of whom had moderate stroke severity (8.68 ± 4.48) and 20.6 ± 12.19 days length of hospital stay. Rehabilitation was initiated within one week of stroke (4.6 days ± 3.37) and total rehabilitation per day was 25.65 ± 15.07 minutes. Mean functional scores were 75/100 (BI) with self-care tasks most affected and 32/40 (MRMI) with mobility (walking) and stair-climbing most affected. Severity of the stroke was found to influence ADLs and mobility outcomes. Moderate, negative, and significant correlation coefficients were found between severity of stroke and mobility (r= -0.50, p < 0.001) as well as ADLs (r = -0.55, p < 0.001). Stroke severity was the only factor that independently influenced functional outcome and mobility at discharge (p < 0.001). The stroke survivors achieved functional independence in some mobility and ADLs variables at discharge, but majority of them still required rehabilitation at the time of discharge from the hospital.