• Marco Franceschini, Stefania Fugazzaro, Maurizio Agosti, Carlotta Sola, Antonio Di Carlo, Lorenzo Cecconi, Salvatore Ferro, and Italian Study Group on Implementation of Stroke Care (ISC Study).
• From the Department of Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy (MF); Department of Neurorehabilitation, San Raffaele University, Rome, Italy (MF); Department of Neuromotor Physiology, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy (S. Fugazzaro, CS); Department of Geriatrics and Rehabilitation, University Hospital Parma, Parma, Italy (MA); Institute of Neuroscience, Italian National Research Council, Florence, Italy (ADC); Statistics Computing and Applications Department, DISA "G. Parenti" Florence University, Florence, Italy (LC); and Hospital Care Service, Regione Emilia-Romagna, Bologna, Italy (S. Ferro).
• Am J Phys Med Rehabil. 2018 Jul 1; 97 (7): 467-475.

PurposeThe aim of the study was to assess early poststroke prognostic factors in patients admitted for postacute phase rehabilitation.MethodsA 1-yr multicenter prospective project was conducted in four Italian regions on 352 patients who were hospitalized after a first stroke and were eligible for postacute rehabilitation. Clinical data were collected in the stroke or acute care units (acute phase), then in rehabilitation units (postacute phase), and, subsequently, after a 6-mo poststroke period (follow-up). Clinical outcome measures were represented using the Barthel Index and the modified Rankin Scale. Univariate and multivariate analyses were performed to identify the most important prognostic index.ResultsModified Rankin Scale score, minor neurologic impairment, and early out-of-bed mobilization (within 2 days after the stroke) proved to be important factors related to a better recovery according to Barthel Index (power of prediction = 37%). Similarly, age, premorbid modified Rankin Scale score, and early out-of-bed mobilization were seen to be significant factors in achieving better overall participation and activity according to the modified Rankin Scale (power of prediction = 48%). Barthel Index at admission and certain co-morbidities were also significant prognostic factors correlated with a better outcome.ConclusionsAccording to the Barthel Index and modified Rankin Scale, early mobilization is an early predictor of favorable outcome.To Claim Cme CreditsComplete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Incorporate prognostic factors of good clinical outcomes after stroke in developing treatment plans for patients admitted to rehabilitation; (2) Identify acute phase indicators associated with favorable 6-mo outcome after stroke; and (3) Recognize the cut-off for early mobilization linked to better outcome in stroke survivors admitted to rehabilitation.LevelAdvanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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