Assessing the potential for functional improvement of stroke patients attending a geriatric day hospital

In the present study the potential for functional improvement in 103 stroke patients attending a geriatric day hospital was evaluated using the Orpington Prognostic Scale (OPS). This information may assist in coordinating the patients' and caregivers' expectations, allocating resources efficiently, and advance care planning. The Spearman correlation was used to calculate the association between OPS score and Functional Independent Measure (FIM), the Nottingham Extended ADL Index (NEAI), and the timed Get Up and Go test (TUG). The studied population was divided into two groups: patients with mild neurological impairment (OPS score<3.2) and those with moderate to severe neurological impairment (OPS score> or =3.2) and their performance on the above outcome measure were compared. The OPS score significantly correlated (p<0.001) with discharge scores of FIM (r=-0.730), NEAI (r=-0.675), and TUG (r=0.448). Patients with OPS score <3.2 achieved significantly higher discharge scores (p<0.001) in all three measures (FIM, TUG, and NEAI) compared to patients with OPS score > or =3.2. Nevertheless, patients with moderate to severe neurological impairment achieved greater score changes in FIM and TUG than patients with mild neurological impairment, although their discharge scores were less favorable. These results indicate that stroke patients even the more impaired, may continually recover and should be exposed to a prolonged rehabilitation program.