Functional outcome in brain stem stroke patients after rehabilitation

Arch Phys Med Rehabil. 1996 Feb;77(2):194-7. doi: 10.1016/s0003-9993(96)90167-7.


Objective: To document functional outcome before and after rehabilitation in a group of brain stem stroke patients and to analyze possible factors influencing outcome.

Design and setting: A case series of 53 consecutive inpatients admitted to a rehabilitation facility with confirmed brain stem strokes over a period of 6 years.

Patients and outcome measures: Patients were selected by physiatrists for admission into the rehabilitation program. Outcome was measured by the Modified Barthel Index (MBI) for mobility and activities of daily living.

Results: The mean age of this cohort was 57.9 +/- 11.9 years and the pons was involved in 55% of cases. Ataxia (68%) and hemiplegia (70%) were the most frequent neurological deficits. Twenty-one patients (40%) had significant dysphagia with risk of aspirin and 16 patients (30%) were incontinent of urine. Aspiration pneumonia and urinary tract infection were present in 8 (15%) and 13 (25%) patients, respectively. Significant improvements in functional status, motor strength, swallowing, and continence status were documented on discharge (p < .05). The total admission MBI was the only significant factor influencing total discharge Barthel Index ( Beta = .597, adjusted R2 = .476, p < .0001). Fifty-one (96%) were discharged home after rehabilitation.

Conclusions: Despite multiple physical deficits, this cohort of brain stem stroke patients made functional gains during rehabilitation with significant improvements in mobility and self-care skills, motor strength, severity of ataxia, continence and swallowing status.

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Stem*
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / physiopathology*
  • Cerebrovascular Disorders / rehabilitation*
  • Female
  • Gait
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Admission
  • Patient Discharge
  • Prognosis
  • Treatment Outcome
  • Urinary Incontinence / etiology