Activity limitations experienced by people with stroke who received inpatient rehabiliation: Differences between 2001, 2005, and 2011

Objective: To determine whether there were differences in characteristics and activity limitations relevant to physiotherapists among people receiving inpatient rehabilitation after stroke in 2001, 2005, and 2011.

Design: A multicenter observational study of 3 periods.

Setting: Inpatient rehabilitation units (N=15).

Participants: Adult stroke survivors (N=738) admitted over 3 periods (2001, 2005, 2011).

Interventions: Not applicable.

Main Outcome Measures: Characteristics, hospital metrics, and Motor Assessment Scale (MAS) scores were recorded on admission and discharge.

Results: All 3 cohorts were similar in terms of sex, side affected by stroke, and length of time from stroke onset to rehabilitation admission. Stroke participants in the 2005 cohort were older than those in the 2011 and 2001 cohorts. Participants in the 2011 cohort had a longer inpatient rehabilitation length of stay, experienced lower average MAS gains per day (F>3.298, P<.038), and experienced more activity limitations in basic functional tasks involving bed mobility, standing up, and sitting balance on admission and discharge, and in walking and arm function at discharge only compared with earlier cohorts.

Conclusions: In 2011, on average, people admitted for rehabilitation after stroke were approximately the same age as patients in 2005 and 2001 and it took approximately 2 weeks for all of these patients to be admitted to a rehabilitation unit, but patients in 2011 had a longer inpatient rehabilitation length of stay compared with patients in 2005 and 2001. In addition, activity limitations at inpatient rehabilitation admission and discharge appear to be worse, particularly for activities such as rolling, sitting up over the edge of the bed, and balanced sitting.