Abstract

Background: Although rehabilitation for the better quality of life reportedly improves motor and cognitive function in post-stroke patients, the factors that prevent good outcomes during rehabilitation are unclear. This study aimed to re-examine the effects of continuous and extensive long-term rehabilitation on motor, cognitive, and total functional independence measures (FIMs) in post-stroke patients in Japan and investigated the novel clinical factors that prevent improvements in FIMs on the top of known preventive factors such as hypertension, age, sex and stroke severity.

Methods: In this prospective observational study, 90 post-stroke patients, admitted to Sankuro Hospital for rehabilitation, were enrolled; the age was 61.4 ± 1.8 years old and 70% were male. The acute phase of stroke treatment took place at mainly the Toyota Memorial Hospital or Toyota Kosei Hospital. In-hospital rehabilitation lasted 80 ± 39 (standard deviation) days. After discharge, all patients continued to receive rehabilitation twice or three times a week for next 12 months. We examined changes in motor, cognitive, and total FIMs and determined which factors negatively impacted improvements in FIMs.

Results: Rehabilitation for one year improved total and motor FIMs (p ＜ 0.01), but not cognitive FIM. Plasma uric acid (p ＜ 0.01 and p ＜ 0.05) and albumin levels (both p ＜ 0.01) were exclusively low in the patient groups with low total or motor FIMs.

Conclusions: In post-stroke patients, continuous and extensive rehabilitation improved total and motor FIMs, but not the cognitive FIM. We also found the differences in plasma uric acid and albumin levels between the groups with high and low total/motors FIMs.