Functional Recovery and Its Predictors after Sub-acute Stroke Rehabilitation in a Nigerian Tertiary Health Facility: A Preliminary Finding

Abstract

Background: Neurorehabilitation remains one of the main methods of treatment in the management of stroke survivors and its early commencement reduces morbidity and improves function. This study assessed motor function recovery after sub-acute stroke rehabilitation and determines factors that predict the recovery. Methods: The cohort prospective study includes 30 consecutive in-patients of a tertiary health facility in Nigeria with primary diagnosis of stroke. Their motor function was assessed at admission and discharge using Functional Independence Measure (FIM) and Modified Motor Assessment Scale (MMAS). Descriptive and inferential statistics were used to analyse the data. Results: Length of rehabilitation/hospital stay ranges between 3 and 60 days (median=16.5 days) and stroke onset interval before admission/rehabilitation ranges between 2 and 28 days (median=8 days). There were significant differences between admission and discharge FIM and MMAS (p=0.001). Only 53.3% achieved Minimal Clinically Important Difference (MCID) in functional recovery as measured by FIM at discharge. Type of stroke (haemorrhagic), motor impairment body side (right) and admission FIM (68.5±30.4) were the predictors of achieving MCID after stroke. Right body side motor impairment are 8 times (OR=7.72; CI=1.08 – 54.97; p<0.05) more likely to achieve MCID in functional recovery compared with left side. The multiple regressions also revealed that stroke type (haemorrhagic) and motor impairment body side were the only significant factors in predicting improved functional recovery after stroke measured by FIM. Conclusion: More than half of stroke survivors achieved MCID in motor function recovery after sub-acute stroke rehabilitation and side of impairment is the major predictor.