Effectiveness of Early Multidisciplinary Rehabilitation on Functional Recovery and Quality of Life in Stroke Survivors

Vollständiger Abstract

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Background: Timely, coordinated rehabilitation after stroke is widely advocated, yet comparative evidence on early multidisciplinary versus conventional models in South Asian tertiary settings remains limited. Objective: This study evaluated whether an early multidisciplinary rehabilitation model improves functional recovery and quality of life compared with conventional stroke rehabilitation. Methods: A prospective comparative cohort of 168 stroke survivors (18–65 years) was enrolled at the Department of Physical Medicine & Rehabilitation, Rajshahi Medical College Hospital, between January 2024 and December 2025, allocated to early multidisciplinary rehabilitation (n=79) or conventional rehabilitation (n=89). Functional outcomes were assessed using the Barthel Index, Functional Independence Measure (FIM), modified Rankin Scale (mRS), and a quality-of-life instrument. Results: Both groups were well matched at baseline (all p>0.05). Post-intervention functional gains were substantial in both arms, with mean Barthel Index improvement of 28.5±4.5 in the early multidisciplinary group versus 27.7±4.7 in the conventional group (p=0.267), and comparable FIM and mRS change (p=0.424 and p=0.832, respectively). Quality-of-life improvement was numerically greater in the conventional group (30.4±6.2 versus 28.2±5.8, p=0.018). Independent of allocated group, shorter time to rehabilitation initiation was associated with greater mRS improvement (r=0.195, p=0.011; adjusted β=0.037, p=0.012). Overall complications occurred in 6 of 168 patients (3.6%), all mild and confined to the conventional arm. Conclusion: Structured rehabilitation delivered promptly after stroke onset, rather than programme labelling alone, appears to be the principal driver of functional recovery in this cohort.