Stroke rehabilitation outcome study: a comparison of Japan with the United States.

Abstract

To compare demographics and functional outcomes in stroke rehabilitation in Japan and the United States. In Japan, 464 consecutive patients with first stroke were enrolled. The United States data were collected from the ninth annual report on patients discharged from medical rehabilitation hospital programs in the United States that subscribe to the Uniform Data System for Medical Rehabilitation. There are many differences between the two countries. Japanese survivors were 10 yr younger, were admitted to the rehabilitation hospital after a markedly longer period of time after the onset of the stroke, had comparably severe impairment on admission, had markedly longer lengths of stay, and had relatively severe disability at discharge. The mean or median admission FIM total score was comparable between Japan and the United States. The mean or median discharge FIM total score of Japanese patients was similar to that of the United States. This may account for the lower rehabilitation efficiency for the Japanese patients. Mean admission FIM total scores in Japan were approximately the same as the discharge FIM scores in the United States data. Rate of discharge to the community was higher in Japan than in the United States.