Impact of intracerebral hemorrhage and cerebral infarction on ADL and outcome in stroke patients: A retrospective cohort study

Article type: Research Article

Authors: Kawakami, Kenji^{a; b; c; *} | Tanabe, Shigeo^{b; c} | Omatsu, Sayaka^a | Kinoshita, Daiki^a | Hamaji, Yoshihiro^a | Tomida, Ken^d | Koshisaki, Hiroo^{c; e} | Fujimura, Kenta^{b; c} | Kanada, Yoshikiyo^{b; c} | Sakurai, Hiroaki^{b; c}

Affiliations: [a] Department of Rehabilitation, Kyoto Rehabilitation Hospital, Kyoto, Japan | [b] Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan | [c] Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan | [d] Fujita Health University Nanakuri Memorial Hospital, Tsu, Japan | [e] Department of Rehabilitation, Nanto Municipal Hospital, Nanto, Japan

Correspondence: [*] Address for correspondence: Kenji Kawakami, RPT, MS, Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-shi, Aichi 470-1192, Japan. Tel.: +81 562 93 2000; E-mail: [email protected].

Abstract: BACKGROUND:The impact of different stroke types on specific activities of daily living (ADL) is unclear. OBJECTIVE:To investigate how differences between intracerebral hemorrhage (ICH) and cerebral infarction (CI) affect improvement of ADL in patients with stroke within a hospital by focusing on the sub-items of the Functional Independence Measure (FIM). METHODS:Patients with first-stroke hemiplegia (n = 212) were divided into two groups: ICH (86 patients) and CI (126 patients). Primary assessments included 13 motor and 5 cognitive sub-items of the FIM assessed at admission and discharge. Between-group comparisons and multiple regression analyses were performed. RESULTS:Upon admission, the ICH group exhibited significantly lower FIM scores than those of the CI group across various activities, including grooming, dressing (upper body and lower body), toileting, bed/chair transfer, toilet transfer, walking/wheelchair, and stairs. Age and FIM motor scores at admission influenced both groups’ total FIM motor scores at discharge, whereas the duration from onset affected only the CI group. CONCLUSION:Several individual FIM motor items were more adversely affected by ICH than by CI. Factors related to ADL at discharge may differ depending on stroke type. Recognizing these differences is vital for efficient rehabilitation practices and outcome prediction.

Keywords: Hemorrhagic stroke, cerebral infarction, cerebrovascular disorder, activities of daily living, functional status, recovery of function

DOI: 10.3233/NRE-240182

Journal: NeuroRehabilitation, vol. 55, no. 1, pp. 41-49, 2024