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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

Chung-Yuan Wang1,2, Seido Miyoshi3, Chang-Hung Chen4, Kai-Chun Lee1, Long-Chung Chang5, Jo-Hsuan Chung6, Hon-Yi Shi6,7,8,9
  • 1Department of Physical Medicine and Rehabilitation, Pingtung Christian Hospital, Pingtung, Taiwan
  • 2Department of Beauty Science, Meiho University, Pingtung, Taiwan
  • 3Department of Rehabilitation, Asagi Hospital, Fukuoka, Japan
  • 4Department of Neurology, Pingtung Christian Hospital, Pingtung, Taiwan
  • 5Superintendent Office, Pingtung Christian Hospital, Pingtung, Taiwan
  • 6Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
  • 7Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan
  • 8Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  • 9Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
Received: November 26, 2019Accepted: April 27, 2020Published: June 1, 2020
https://doi.org/10.18632/aging.103288

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.