The impact of somatosensory function on activity performance and length of hospital stay in geriatric patients with stroke

Objective: To investigate in geriatric patients with stroke the relationship between somatosensory function, activity performance and the length of stay (LOS) in either hospital or nursing home. Design: Survey. Setting: Stroke unit and geriatric rehabilitation unit. Subjects: One hundred and fifteen consecutive patients with acute stroke greater than or equal to65 years old. Main outcome measures: Clinically assessed somatosensory function, activity of daily living according to the Barthel Index (BI) ( 0 - 100 points), mobility according to the Rivermead Mobility Index (RMI) ( 0 - 15 points) and LOS. Results: Ten days after stroke onset, the patients with normal (n = 46), impaired ( n = 31) and nonassessable ( n = 38) somatosensory function scored 85, 40 and 0 points respectively on the BI, and 8.5, 2 and 0 points respectively on the RMI. Forty-one of 46 patients (89%) with normal somatosensory function were discharged home within three months, compared with 10 of 31 patients (32%) with impaired somatosensory function and three of 38 patients (8%) who were nonassessable. These between-group differences were statistically significant ( p < 0.001). Multiple regression, to adjust for the impact of age, social situation and bladder function on outcome still proved a statistically significant ( p < 0.001) predictive value of normal somatosensory function. Conclusions: Normal somatosensory function is related to high activity levels and short LOS more often than somatosensory impairment is related to activity limitations and long LOS.