Characteristics of disability in stroke patients (measured by the FIM)

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We investigated some characteristics of stroke patients, considered the variables : length of stay, Functional Independence Measure (FIM) score at hospitalization and discharge, length of time from the onset, and FIM gain. We calculated the FIM efficiency per month. The subjects were 164 inpatients with stroke. Their average age was 54.4 years. Of the 164 patients, 68 had had cerebral infarction, 80 had had cerebral hemorrhage and 16 had had subarachnoid hemorrhage. Seventy three had sustained damage in their left hemisphere, 91 in their right. An average of 114.5 months had passed since they had suffered from stroke. Their mean length of stay was 108.7 days.The average FIM score at hospitalization was 84.0±19.6 and that at discharge was 101.7±17.8. There was no significant difference in FIM score among different types of disease both at hospitalization and discharge. But it was higher in patients with subcortical lesion than those with cortical lesion. And it was lower in patients with hemispatial neglect or patients whose Mini Mental State Examination scores were lower than 21. The length of stay tended to be longer in patients whose FIM score at hospitalization was low and FIM gain was high. The FIM gain was usually high during the early stage of hospitalization, but it could be seen even in the late stage. We found that although the length of stay was not short, even the patients who had a low FIM score could make FIM gain with proper rehabilitation exercise.There were several stroke patients whose FIM score decreased after they went back to the community, especially those whose FIM motor score at discharge was in the seventies. We guessed that one of the reasons for this reduction was unnecessary help of the patients by the family. Education for the patient's family on how to care for disabled people in their home is important to the success of community based rehabilitation.