Recovery after stroke--the first 3 months

• Published in: Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1985-01, Vol.48 (1), p.7-13
• Main Authors: Wade, D T, Wood, V A, Hewer, R L
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Biological and medical sciences; Cerebral Infarction - mortality; Cerebral Infarction - rehabilitation; Disability Evaluation; Female; Follow-Up Studies; Hemiplegia - rehabilitation; Humans; Male; Medical sciences; Middle Aged; Neurologic Examination; Neurology; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.48.1.7

Ninety-nine patients had their function recorded regularly over the first 13 weeks after their stroke. Five functional areas were studied: urinary continence, mobility, the ability to dress, feeding, and the ability to transfer from bed to chair. Thirty-two patients died before 13 weeks. Forty-five of the 67 survivors had assessments twice weekly from within 4 days of their stroke. Recovery in these 45 patients occurred fastest in the first 2 weeks, by which time at least 50% of recovery had occurred, but it was still continuing at 13 weeks. Urinary incontinence present between 7 and 10 days after stroke was the most important adverse prognostic factor both for survival and for recovery of function. Age was the second most important factor. Hospital discharge seemed to occur once recovery had stopped, although four of the 49 patients discharged had been fully independent for at least 12 days prior to discharge. It is suggested that rehabilitative therapy should concentrate less on physical function and more on cognitive ability.