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Background: The growing interest in documenting the effectiveness of rehabilitation has led to a progressive increasing focus on clinical tools to measure stroke-survivors disability and recovery. In clinical practice a general agreement on the instruments to be used seems to be lacking and clinical scales are often limited to the assessment of global function., Aim: The study investigated whether the use of a selection of clinical scales/scores added to a single global measure during rehabilitation care, may lead to a better functional outcome for stroke inpatients., Design: Retrospective study., Setting: Neurorehabilitation inpatients., Population: Consecutive patients affected by first-ever stroke., Methods: Patients in the control group (CG) (N.=139) were assessed at admission and at discharge with the Functional Independence Measure (FIM), while patients in the study group (SG) (N.=127) were evaluated by means of a basic core-set of clinical scales/scores as well as with the FIM. Patients in both groups were evaluated and treated by the same multiprofessional team, following the same rehabilitative treatment approaches., Results: At discharge both groups significantly improved at the FIM total Score, compared to the admission; a significant improvement was also reported for all the clinical scales in SG. However, the CG showed longer length of stay (LOS) than the SG and between-group analysis revealed statistical significant differences in the FIM total score, in the FIM gain and in all the indices of performance (FIM efficiency, FIM absolute efficacy, FIM relative efficacy), in favor of the SG., Conclusions: The use of a selection of scales added to a global functional measure, allows a better definition of both the person's profile of disability and the rehabilitative goals, and is associated to a better functional outcome at discharge., Clinical Rehabilitation Impact: Clinical scales may be used in clinical practice to better define the person's profile of disability, allowing the design of patient tailored goals, and to favor team working.

Weight bearing on the paretic lower extremity and transfer of weight from one lower extremity to the other are important goals of stroke rehabilitation. Improvements in these limb loading and weight transfer abilities have been shown to relate to improved performance of many functional activities. Unfortunately, valid and practical clinical measures of paretic lower extremity loading and weight transfer have not been identified. The purpose of this study was to quantitatively assess, through center of foot pressure (CoP) analysis of quiet upright stance control, recovery of paretic limb loading as a measure of weight transfer in early stroke subjects, testing the effectiveness of a targeted rehabilitation intervention based on audiovisual biofeedback. Thirty-seven adults with lower extremity motor impairment following unilateral, non-cerebellar stroke, were Biofeedback rehabilitation of posture and weightbearing distribution in stroke: a center of foot pressure analysis tested twice, at an interval of at least one month post stroke and following rehabilitation intervention aimed at correcting their asymmetrical weight bearing. The intervention was performed with (Study Group, SG) or without (Control Group, CG) a postural audio-visual biofeedback approach. Indices of postural stability and of balance control asymmetry were estimated by acquiring the movements of the CoP during quiet upright stance condition with or without visual input (eyes open, EO and eyes closed, EC). Clinical scales were also administered. Both the CG and the SG subjects showed improved control in upright stance posture as documented by significant improvements in the scale scores and indices of stability during both the EO and the EC condition. Only the SG showed a significantly reduced CoP index of asymmetry. The CoP index of asymmetry, correlating with clinical motor scales, is a valid measure of paretic limb loading during stroke recovery. Postural audio-visual biofeedback represented the more effective approach for reducing weight loading asymmetry of the lower limbs in stroke.

The aim of this study was to compare the effectiveness in acute stroke patients of a rehabilitation program performed with or without an arm weight support device. Twenty-eight acute, first-ever unilateral stroke patients were enrolled in a single-blind, randomized controlled trial. Clinical evaluation included Fugl-Mayer Assessment, Functional Independence Measure and kinematic analysis [maximum and mean hand velocity, maximum range of motion (Max RoM), normalized jerk (NJ)]. Patients received 12 daily 30-minute sessions (6/week) of additional upper limb therapy performed using an arm weight support device (study group) or additional traditional physiotherapy (control group). The patients were evaluated on admission and at the end of the rehabilitation intervention. The two groups were clinically comparable on admission (p>0.05). Both groups showed significant improvements in clinical scale scores and in Max RoM in flexionextension, while only the study group showed improvements in NJ and in Max RoM in adductionabduction. Rehabilitation training using an arm weight support device appears to be a useful method to supplement conventional therapy in acute stroke patients, increasing smoothness of movement and motor function.