Disclosures: Talya K. Fleming, MD, FAAPMR: American Heart Association / American Stroke Association of New Jersey (Products/Services: No) (Speaker/Honoraria includes speakers bureau, symposia, and expert witness, Voluntary, Speaker’s Bureau)Fred C. Rummel Foundation (Products/Services: No) (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received, Research Grant, Principal Investigator, Funds assigned to Primary institution)NeuroTech (Products/Services: No) (Consultant/Advisory Board, Voluntary, Advisory Board)NuStep (Products/Services: No) (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received, Research Grant, Principal Investigator, Funds assigned to Primary institution)

Background and/or Objectives: Examine the effects of the comprehensive outpatient stroke recovery program (SRP) on functional recovery and living setting of stroke survivors following discharge from an inpatient rehabilitation facility (IRF).

Design: Matched-cohort study

Setting: Suburban academic medical center with inpatient and outpatient rehabilitation facilities

Participants: A total of 282 patients admitted to an IRF with stroke diagnosis from 2016-2019 were included in this analysis. Of 282 patients, 167 participated in the SRP and 115 patients received standard of care therapies. Both cohorts were matched for stroke type, age, gender, race, medical complexity and baseline functional scores.

Interventions: A comprehensive outpatient SRP for stroke survivors including physician visits for risk factor education, rehabilitation therapies, and a customized modified cardiac rehabilitation program (36-sessions of cardiovascular conditioning).

Main Outcome Measures: Activity Measure for Post-Acute Care (AM-PAC) scores for Basic Mobility, Daily Activities, and Applied Cognitive were collected for all patients at admission and discharge from IRF and 120-days post-stroke (post-completion of rehabilitation therapies). In addition, the living setting of patients (home versus skilled nursing facility) was compared at 120-days post-stroke.

Results: Repeated measures ANOVA demonstrated at 120-days post-stroke, SRP-participants had significantly higher AM-PAC rate of change in all 3 domains compared to non-participants (p < 0.001). Analysis of AM-PAC functional stages revealed SRP-participants with significantly more patients moving outdoors, independence with self-care, and achieving multi-step complex tasks compared with non-participants reporting limited moving indoors, struggle with daily tasks and limitations in communication (Chi-square, p < 0.001). Moreover, 99% of SRP-participants were living at home 120-days post-stroke, whereas only 83% of non-participants were at home, with 17% living in a skilled nursing facility (Chi-square, p < 0.001).

Conclusions: These results demonstrate significant improvements with SRP not only in functional recovery but also importantly in the living setting of stroke survivors. This study emphasizes the need for comprehensive outpatient rehabilitation for stroke survivors.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/trajectory-of-functional-recovery-and-living-setting-of-stroke-survivors-a-cohort-study-comparing-patients-who-participated-in-the-comprehensive-stroke-recovery-program-with-the-standard-of-care/