Impairment and disability: their relation during stroke rehabilitation

Archives of Physical Medicine and Rehabilitation
Elliot J RothS Diaz

Abstract

To describe the association between impairment and disability during stroke rehabilitation and to examine the effects of rehabilitation by studying the degree of disability reduction experienced by stroke patients who did not have significant reductions in impairment levels. Statistical analysis of items from a database of prospectively collected information on stroke patients admitted for rehabilitation. Large urban academic freestanding rehabilitation facility. Four hundred two patients consecutively admitted for comprehensive acute stroke inpatient rehabilitation. The National Institutes of Health Stroke Scale (NIHSS) was used to measure impairment and the Functional Independence Measure (FIM) was used to measure disability. Motor and cognitive subscales of the FIM instrument were evaluated. Raw NIHSS and FIM scores were converted to linear measures using Rasch analysis. Relationships were studied between converted NIHSS and the two FIM subscales for admission, discharge, and change scores using linear regression analysis. In a second analysis, two groups of patients were identified; the 342 patients who experienced no substantial reduction of impairment comprised the "no impairment reduction (NIR) group," and the 60 patient...Continue Reading

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