Research Paper Volume 12, Issue 11 pp 10704—10714
Walking ability and functional status after post-acute care for stroke rehabilitation in different age groups: a prospective study based on propensity score matching
- 1 Department of Physical Medicine and Rehabilitation, Pingtung Christian Hospital, Pingtung, Taiwan
- 2 Department of Beauty Science, Meiho University, Pingtung, Taiwan
- 3 Department of Rehabilitation, Asagi Hospital, Fukuoka, Japan
- 4 Department of Neurology, Pingtung Christian Hospital, Pingtung, Taiwan
- 5 Superintendent Office, Pingtung Christian Hospital, Pingtung, Taiwan
- 6 Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
- 7 Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan
- 8 Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- 9 Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
Received: November 26, 2019 Accepted: April 27, 2020 Published: June 1, 2020
https://doi.org/10.18632/aging.103288How to Cite
Copyright © 2020 Wang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Few studies have compared how rehabilitative post-acute care affects recovery of walking ability and other functions after stroke in different age groups. After propensity score matching (1:1), 316 stroke patients were separated into an aged group (age ≥65 years, n=158) and a non-aged group (age <65 years, n=158). Both groups significantly improved in Barthel index, EuroQol-5 dimension, Berg balance scale, 6-minute walking distance and 5-meter walking speed (P<0.001). The non-aged group had significantly larger improvements in Berg balance scale, instrumental activities of daily living, EuroQol-5 dimension and 6-minute walking distance (P<0.001) compared to the aged group. The two groups did not significantly differ in Barthel index, 5-meter walking speed, length of stay, and cost. The aged group had poorer walking ability and poorer instrumental activities of daily living compared to the non-aged group. After intensive rehabilitative post-acute care, however, the aged group improved in walking ability, functional performance and mental health. Intensive strength training for unaffected lower limbs in the stroke patients achieved good recovery of walking ability and other functions. Overall, intensive rehabilitative post-acute care improved self-care ability and decreased informal care costs. Rehabilitative PAC under per-diem reimbursement is efficient and economical for stroke patients in an aging society.