Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
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Abstrakt

Prognosis and Classification of Severely Hemiplegic Stroke Patients in a Rehabilitation Hospital

Yoshitake Hirano, Osamu Nitta, Takeshi Hayashi, Hidetoshi Takahashi, Yasuhiro Miyazaki and Hiroshi Kigawa

Objective: When carrying out rehabilitation during convalescence, the prognosis must be considered before treatment, and guidance needs to be provided to patients and their families. However, predicting the prognosis and final outcomes of patients with severe hemiplegia is challenging since the condition is influenced by various factors in a complex manner. The aim of this study was to identify prognosis factors for the outcomes of severely hemiplegic stroke patients on the basis of evaluations conducted at the time of admission to rehabilitation. Methods: The subjects were 80 first-time stroke patients presenting with severe hemiplegia. They were divided into groups by their properties and physical function on admission. The groups were compared by their properties, physical function on admission, and outcomes. Results: According to these factors, the patients were divided into 3 groups: “good cognitive function and good muscle strength in the lower extremity on the non-paralyzed side (A group),” “poor cognitive function and poor motor function (B group),” and “good cognitive function and good motor function(C group)” by cluster analysis. At the end of the rehabilitation period, the patients in the B group had a significantly worse ability to walk and to perform ADL than the patients in the A and C groups, and only a few patients from the B group were able to return home. Conclusion: We concluded that the classification of severely hemiplegic stroke patients is useful to predict prognosis in a rehabilitation hospital.