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Objective：To clarify the effect of exclusion items on the KRW achievement index (KRW-AI) in the outcome evaluation of a convalescent rehabilitation ward.Methods：The subjects were 812 inpatients in a convalescent rehabilitation ward. The objective variable was the KRW-AI of 40 or less, and the explanatory variables were the items excluded from the KRW-AI and their combination for a total of eight categories, such as (1) low motor FIM, (2) high motor FIM, (3) low cognitive FIM, (4) elderly, (5) (1)＋(3), (6) (1)＋(4), (7) (3)＋(4), (8) (1)＋(3)＋(4). The adjusted variables were sex, rehabilitation calculation category, and time from onset to admission to the ward. Poisson regression analysis was performed. The Incidence Rate Ratio (IRR) and 95％ confidence interval (CI) were calculated.Results：Five of the eight exclusion categories were significantly associated with low-KRW-AI scores. The highest IRR was 2.29 (95％ CI：1.41-3.69, p＜0.001) for (2).Conclusion：High motor FIM are associated with a higher relative risk of falling below the KRW-AI of 40. Conversely, being older and the presence of cognitive disorder did not interfere with low-KRW-AI scores.
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Objective：To clarify the effect of exclusion items on the KRW achievement index (KRW-AI) in the outcome evaluation of a convalescent rehabilitation ward.Methods：The subjects were 812 inpatients in a convalescent rehabilitation ward. The objective variable was the KRW-AI of 40 or less, and the explanatory variables were the items excluded from the KRW-AI and their combination for a total of eight categories, such as (1) low motor FIM, (2) high motor FIM, (3) low cognitive FIM, (4) elderly, (5) (1)＋(3), (6) (1)＋(4), (7) (3)＋(4), (8) (1)＋(3)＋(4). The adjusted variables were sex, rehabilitation calculation category, and time from onset to admission to the ward. Poisson regression analysis was performed. The Incidence Rate Ratio (IRR) and 95％ confidence interval (CI) were calculated.Results：Five of the eight exclusion categories were significantly associated with low-KRW-AI scores. The highest IRR was 2.29 (95％ CI：1.41-3.69, p＜0.001) for (2).Conclusion：High motor FIM are associated with a higher relative risk of falling below the KRW-AI of 40. Conversely, being older and the presence of cognitive disorder did not interfere with low-KRW-AI scores.
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In Guillain Barre Syndrome (GBS), there is symmetrical muscle weakness which ranges from mild weakness to severe palsy of all limbs. The motor symptoms start distally and move proximally. Proximal muscle weakness is primary and common factor in GBS. To overcome the weakness, one has to strengthen the muscle. Muscle activity of proximal segment is necessary for activation of distal segment. In fact, stable activity of distal parts needs controlling of the proximal parts. As distal muscle weakness is a major problem in post GBS individuals, they need to be facilitated with the help of proximal muscle strengthening. MethodsAfter obtaining the ethical committee clearance an experimental study was conducted among a total of 30 GBS subjects selected through convenience sampling. OPD subjects were given proximal muscle strengthening for 6 weeks. Each subject was examined by modified sphygmomanometer test (MST) and functional independence measure scale (FIMS) before and after the study. ResultsResult was calculated by using MST and FIMS. Exercises showed extremely significant difference on MST [p = 0.0001, t = 11.924] on handgrip strength, [p value = 0.0001) t = 12.334] on plantar flexion, [p value = 0.0001, t = 9.558] on dorsiflexion. FIMS [p value = 0.0001, t = 25.699] extremely significant difference was seen. ConclusionsProximal muscle strengthening is found to be effective for distal muscle facilitation in Guillain Barre Syndrome.
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Pressure ulcers have been associated with an extended length of hospitalization, sepsis and mortality. Over the last few decades, little has been written about the impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. It is obvious that critically ill patients, who are sedated, ventilated, patients with chronic neurological, musculoskeletal and cardio-respiratory disorders who are bed ridden for prolonged period of time are particularly at risk of developing skin breakdown. This will help in identifying barriers to patient participation and develop strategies to pressure ulcer prevention. We wanted to determine the impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. MethodsThe study was conducted from June 2015 to January 2016. The impact of pressure ulcer on inpatient physiotherapy services was determined by detailed physical assessment, evaluation with Functional Independence Measure score (FIM) and Braden Q Scale. A total 96 subjects were assessed during this time. ResultsThere was statistically significant impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. The FIM takes into consideration self-care, sphincter control, transfers, locomotion, communication social cognition. A poor score denotes poor outcome at discharge. Tissue level assessment was carried out by using Braden Q Scale, a poor score of which again denotes very poor outcome in mobility, activity, sensory perception, moisture, friction – shear, nutrition, tissue perfusion and oxygenation. ConclusionsPressure ulcer is one of the preventable problems; but in majority of cases it becomes the main reason for poor therapeutic outcome.
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It remains unclear how much rehabilitation training is suitable for stroke patients aged ≥ 75 years. To investigate this, especially in convalescent rehabilitation wards, we studied 65 patients (28, ≦ 74 years；37 ≧ 75 years) with cerebral infarction hospitalized in the acute care ward and then in a convalescent rehabilitation ward. From their medical records, we collected data regarding the length of their hospital stay, total amount of rehabilitation training, and activities of daily living evaluated using the total scores of the functional independent measure (FIM) measured on admission to the acute care and convalescent rehabilitation wards, respectively. From these data, we calculated the absolute functional gain, relative functional gain, and average amount of rehabilitation training per day. The correlation of each item and age was analyzed. Items that significantly correlated with age were compared between ≦ 74 and ≧ 75 years age groups. As a result, the absolute functional gain and average amount of rehabilitation training per day were not significantly different between groups. The relative functional gain was significantly lower in the ≧ 75 years group than in the ≦ 74 years group. The total FIM scores at discharge showed a positive correlation with the amount of rehabilitation training in patients aged ≧ 75 years. We believe that a large amount of rehabilitation training is beneficial for patients aged ≧ 75 years with cerebral infarction.
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It remains unclear how much rehabilitation training is suitable for stroke patients aged ≥ 75 years. To investigate this, especially in convalescent rehabilitation wards, we studied 65 patients (28, ≦ 74 years；37 ≧ 75 years) with cerebral infarction hospitalized in the acute care ward and then in a convalescent rehabilitation ward. From their medical records, we collected data regarding the length of their hospital stay, total amount of rehabilitation training, and activities of daily living evaluated using the total scores of the functional independent measure (FIM) measured on admission to the acute care and convalescent rehabilitation wards, respectively. From these data, we calculated the absolute functional gain, relative functional gain, and average amount of rehabilitation training per day. The correlation of each item and age was analyzed. Items that significantly correlated with age were compared between ≦ 74 and ≧ 75 years age groups. As a result, the absolute functional gain and average amount of rehabilitation training per day were not significantly different between groups. The relative functional gain was significantly lower in the ≧ 75 years group than in the ≦ 74 years group. The total FIM scores at discharge showed a positive correlation with the amount of rehabilitation training in patients aged ≧ 75 years. We believe that a large amount of rehabilitation training is beneficial for patients aged ≧ 75 years with cerebral infarction.
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<p>Objective：The aim of this study was to examine the efficacy and safety of hochuekkito to address reduced activities of daily living (ADL), nutritional status, and immunity in patients with severe conditions, represented by a functional independence measure (FIM) total score of ≤ 40.</p><p>Methods：Thirty-one patients who were undergoing rehabilitation for hemiplegia after cerebrovascular disease were randomized into 2 groups：those treated with hochuekkito (TJ-41 group) and those treated without hochuekkito (control group). Their conditions were observed for 24 weeks, focusing on items such as ADL and incidence of inflammatory complications.</p><p>Results：The FIM total score markedly improved after treatment in both groups, but the changes in the score between admission and discharge were similar between the two groups. The incidence of inflammatory complications was significantly lower in the TJ-41 group (P = 0.049). Among the patients with a motor FIM score of ≤ 20, those in the TJ-41 group showed a tendency of increase in total lymphocyte count after treatment. No adverse drug reactions were observed during the study period.</p><p>Conclusion：These results suggest that hochuekkito is effective in reducing the incidence of inflammatory complications in patients undergoing rehabilitation for cerebrovascular or other diseases.</p>
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<p>Purpose：To clarify factors related to changes in activities of daily living (ADL) among elderly patients who were discharged to home.</p><p>Methods：The subjects were 88 persons who received in-hospital musculoskeletal rehabilitation and discharged to home. Factors related to changes in functional independence measure (FIM) score were examined.</p><p>Results：The factors related to restoring the FIM score to its values before hospitalization were frequency of physical exercise at 1 week (odds ratio [OR] ＝1.41) and 1 month (OR＝1.27) after hospital discharge, restoring the FIM score at hospital discharge to its value before hospitalization (OR＝3.96), and feeling of self-efficacy (OR＝1.16) at 3 months after hospital discharge. A receiver-operating characteristic analysis revealed that the factors related to restoring the FIM score to its value before hospitalization were frequency of physical exercise (cutoff value＝1.5) at 1 week after discharge, frequency of physical exercise (cutoff value＝1.0) at 1 month after discharge, and feeling of self-efficacy (cutoff value＝31.5) at 3 months after discharge. In addition, ≥ 2 days of physical exercise per week after hospital discharge was more likely to lead to high FIM score than ＜ 2 days of physical exercise per week.</p><p>Conclusion：Our results implied that regular physical exercise soon after hospital discharge would lead to better prognosis</p>
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Objective To investigate the effect of electroacupuncture plus early rehabilitation training on the function recovery after surgery for cervical spinal cord injury. Methods Sixty patients with cervical spinal cord injury undergone anterior cervical decompression and internal fixation were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by electroacupuncture plus rehabilitation training, while the control group was by rehabilitation training alone. The Frankel’s grading (FG), Barthel Index (BI), and Functional Independence Measure (FIM) were adopted for evaluation before and after intervention. Results The FG was not significantly changed after intervention in both groups (P>0.05). After intervention, there was no significant difference in comparing FG between the two groups (P>0.05). The BI and FIM scores were significantly changed after intervention in both groups (P＜0.01). There were significant differences in comparing BI and FIM scores between the two groups (P＜0.05). Conclusion Electroacupuncture plus early rehabilitation training can promote the function recovery after surgery for cervical spinal cord injury, and improve the quality of life.
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This study sought to elucidate the relationship between units of rehabilitative training time and Functional Independence Measure (FIM) at time of discharge in femoral neck fracture patients. The subjects were 795 patients with femoral neck fracture from 19 hospitals registered in the Japan Rehabilitation Database who satisfied the inclusion criteria. Separating these into 15 hospitals (371 cases) where surgery was performed at outside institutions and 14 hospitals (424 cases) where surgery was performed in-house, multiple regression analysis was performed using six explanatory variables including hospital dummy and training time units, and motor FIM score at discharge as an objective variable. In the outside surgery group, whose training time units ranged from 0.8 to 8.6, the coefficient was not significant. However, it became significant when narrowed to two hospitals comprising more than 50 cases (<i>B</i>=2.187). The in-house surgery group's training time units represented a significantly positive coefficient (1.427). It is thought that if the number of training time units used for patients with femoral neck fractures increases by one unit, then the patient's motor FIM score at discharge will rise about 1.4 to 2 points.
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<p><b>INTRODUCTION</b>An observational study was carried out to estimate the strength of the relationships among balance, mobility and falls in hemiplegic stroke inpatients. The objective was to examine factors that may aid in the prediction of the likelihood of falls in stroke patients.</p><p><b>METHODS</b>A total of 53 stroke patients (30 male, 23 female) aged 67.0 ± 11.1 years were interviewed regarding their fall history. Physical performance was assessed using the Berg Balance Scale (BBS) and the Functional Independence Measure (FIM) scale. Variables that differed between fallers and non-fallers were identified, and a discriminant function analysis was carried out to determine the combination of variables that effectively predicted fall status.</p><p><b>RESULTS</b>Of the 53 stroke patients, 19 were fallers. Compared with the non-fallers, the fallers scored low on the FIM, and differed with respect to age, time from stroke onset, length of hospital stay, Brunnstrom recovery stage and admission BBS score. Discriminant analysis for predicting falls in stroke patients showed that admission BBS score was significantly related to the likelihood of falls. Moreover, discriminant analysis showed that the use of a significant BBS score to classify fallers and non-fallers had an accuracy of 81.1%. The discriminating criterion between the two groups was a score of 31 points on the BBS.</p><p><b>CONCLUSION</b>The results of this study suggest that BBS score is a strong predictor of falls in stroke patients. As balance is closely related to the risk of falls in hospitalised stroke patients, BBS might be useful in the prediction of falls.</p>
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Aged , Female , Humans , Male , Middle Aged , Accidental Falls , Discriminant Analysis , Hemiplegia , Postural Balance , Risk Assessment , Risk Factors , Severity of Illness Index , Stroke , Stroke RehabilitationABSTRACT
Background : The effects of rehabilitation on hemodialysis patients are unknown. We assessed the effects and investigated the association between rehabilitation treatment effects and all-cause mortality. Methods : This prospective cohort study included 120 patients on maintenance hemodialysis. ADL was assessed using the Functional Independence Measure (FIM) score (total points, 126), which comprises 13 motor items (total points, 91) and five cognitive items (total points, 35). A survival curve was constructed using the Kaplan-Meier analysis and stratified into an increase or no-increase of the FIM score. Multivariable logistic regression analysis was used to determine factors associated with the effects of rehabilitation. Discriminative sensitivity of FIM cognitive items for an increase in total FIM was estimated using the area under the receiver operating characteristic (AuROC) curve. Results : The average total FIM score increased from 64.2±3.6 to 75.8±3.0, and the increase in FIM motor and cognitive items was 11.0±1.3 and 0.5±0.6, respectively. The cumulative survival rate within 2.5 years was significantly higher in the FIM increase group than that in the FIM no-increase group. FIM cognitive items and anemia were significantly associated with rehabilitation effects, and AuROC showed that a cutoff of 34 points in cognitive FIM had moderate discriminative sensitivity for a total FIM increase (AuC, 0.719 ; <i>p</i><0.0008). Conclusions : Rehabilitating hemodialysis patients improved their FIM score (particularly the motor items), and a higher FIM score resulted in a better prognosis. The effectiveness of rehabilitation depends on maintaining a perfect FIM cognitive score.
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Introdução: O Acidente Vascular Encefálico (AVE) constitui uma das principais causas de internações e mortalidade, causando, em cerca de 90% dos sobreviventes, algum tipo de deficiência, seja ela parcial ou total. Os comprometimentos funcionais variam de um indivíduo para o outro e o desempenho das habilidades de atividades de vida diária (AVD) são fortemente prejudicados. Objetivos: Avaliar a independência funcional de indivíduos na fase crônica após AVE e verificar a sua relação com a realização de tratamento fisioterapêutico. Materiais e métodos: A amostra constou de 69 hemiparéticos crônicos com média de idade de 64-65 anos. Para avaliar a funcionalidade, utilizou-se a Medida de Independência Funcional(MIF) e foram determinados os efeitos chão e teto. A análise estatística incluiu o teste de normalidadede Kolmogorov-Smirnov, média e desvio-padrão, e o teste de Mann-Whitney. Resultados: Segundo o domínio motor da MIF, o item controle de esfíncteres (fezes) apresentou o maior número de indivíduos realizando de forma totalmente independente (88,4%) e o item subir e descer escadas foi o que obteve menor escore. Todos os itens do domínio cognitivo obtiveram médias superiores a 6,4 pontos. Foi encontrado elevado efeito teto para ambos os domínios, motor e cognitivo. Apenas a dimensão transferências diferiu significativamente entre os que faziam e os que não faziam fisioterapia (p = 0,01). Conclusão: De modo geral, não houve relação entre a independência funcional e a realização da fisioterapia. Entretanto,o elevado efeito teto pode ter interferido nos resultados, sugerindo limitação da MIF em discriminar osindivíduos avaliados
INTRODUCTION: Stroke is a leading cause of hospitalization and mortality, causing some type of disability in approximately 90% of survivors, whether partial or total. The functional impairment varies from one individual to the other and the performance skills of activities of daily living (ADLs) are strongly affected. OBJECTIVES: To assess the functional independence of individuals in the chronic phase after stroke and to determine its relation with the treatment by physiotherapy.MATERIALS AND METHODS: The sample consisted of 69 chronic hemiparetic individuals with a mean age of 64-65 years old. In order to evaluate the functionality, the Functional Independence Measure (FIM) was used and the floor and ceiling effects were determined. Statistical analysis included the normality test of Kolmogorov-Smirnov, mean and standard deviation and the Mann-Whitney test. RESULTS: According to the FIM motor domain, the item "sphincter control (feces)" had the highest number of individuals performing totally independently (88.4%) and the item "going up and down the stairs" showed the lowest scores. All items in the cognitive domain had means higher than 6.4 points. Ceiling effect for both motor and cognitive areas was found. Only the transfer dimension differed significantly between those who did and those who did not do physical therapy (p = 0.01).CONCLUSION: Overall, there was no relation between functional independence and physical therapy. However, the ceiling effect may have influenced the results, suggesting MIF restriction in discriminating the evaluated individuals.
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Humans , Male , Female , Middle Aged , Aged , Anal Canal , Stroke/therapy , Paresis , Physical Therapy ModalitiesABSTRACT
The purpose of this study was to analyze the socioeconomic factors influencing patient discharge destination and the length of their hospital stay. We investigated 83 consecutive stroke patients admitted to our rehabilitation ward between January 1 and December 31, 2008. The mean age was 68.1 years old, the mean length of stay was 86.1 days, and 57% were men. The outcome for this study was the patient discharge destination, defined as home or a nursing home type of facility. To examine the predictors of the discharge destination, we collected data including patient age, sex, total Functional Independence Measure (FIM) scores at discharge, ‘living alone’, ‘over 65 years old’, ‘requiring public assistance’, and ‘having a family member at home who requires nursing care’. In all, 69 patients were able to return home, and 14 patients were discharged to a nursing home type of facility. The home group showed a higher total FIM score (p<0.001). Logistic regression analysis showed that two factors, ‘living alone’ and ‘having a family member at home who requires nursing care’, adversely affected patient discharge to home. Also, the length of stay was longer among those patients who required public assistance (p<0.01). This study suggests that it is harder for patients to be discharged back to their homes who have these factors : ‘having a family member at home who requires nursing care’ and ‘living alone’. Additionally, having the patient characteristic of ‘requiring public assistance’ could prolong the length of hospital stay.
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Fundamentos: A cirurgia cardíaca é uma forma de tratamento que, apesar de trazer melhora para o paciente, acarreta alterações no organismo. Objetivo: Avaliar a influência da dor, na primeira cirurgia e na reoperação com uso de circulação extracorpórea (CEC), na medida de independência funcional (MIF). Métodos: Foram estudados 22 pacientes cardiopatas, internados na Fundação de Beneficência Hospital de Cirurgia, submetidos à cirurgia cardíaca eletiva por toracotomia médio-esternal (TME) com uso de circulação extracorpórea (CEC) no período de março a abril 2010. Utilizou-se o questionário da medida de independência funcional (MIF) e a escala de dor pela escala visual analógica (EVA) no pré-operatório, 2º/3º dias pós-operatórios (DPO) e 5º/6º DPO. Resultado: Houve uma redução da dor do 2º/3º DPO para o 5º/6º DPO; uma perda de desempenho funcional do pré-operatório para o 2º/3ºDPO e um ganho deste do 2º/3º DPO para 5º/6º DPO com p<0,001. Não se obteve uma correlação significante entre a dor e o quantitativo cirúrgico com o desempenho funcional, apenas deste com o tempo de CEC, que se mostrou inversamente proporcional. Conclusão: A dor, na primeira cirurgia e na reoperação, não influenciou a medida de independência funcional, sendo apenas influenciada pelo tempo de CEC.
Background: Cardiac surgery is a form of treatment that causes changes in the body, although offering improvement for the patient. Objective: To evaluate the influence of pain during the initial surgery and reoperation with the use ofcardiopulmonary bypass (CPB) on the functional independence measure (FIM).Methods: This study focused on 22 cardiac patients in the Fundação de Beneficência Hospital de Cirurgia(FBHC) hospitalized for elective heart surgery through mid-sternal thoracotomy (MST) with cardiopulmonary bypass (CPB) between March and April 2010, using thefunctional independence measure (FIM) questionnaire and the Visual Analog Scale (VAS) for pain in the preoperative, 2/3 and 5/6 PODs. Results: Pain reduction was noted between 2/3 and 5/6 PODs; a loss of functional performance between the preoperativeperiod and the 2/3 PODs; and a gain between the 2/3 and 5/6 PODs with p<0.001. No statistically significant correlation was found between pain and the amount of surgery with functional performance, but only between the latter and the duration of the CPB, whichwas inversely proportional. Conclusion: Pain caused by the first surgery andreoperation did not affect the functional independence measure, which was influenced only by the CPB.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Thoracic Surgery/methods , Pain, Postoperative/surgery , Cardiovascular Surgical Procedures/methods , Cardiovascular Surgical Procedures/rehabilitation , Extracorporeal Circulation/methods , Extracorporeal CirculationABSTRACT
@#ObjectiveTo investigate the effect of the recreational therapy on the ability of social communication in stroke patients. Methods58 cases of stroke patients were divided into recreational group (28 cases) and control group (30 cases). All of them received routine rehabilitation therapy, while the recreational group received the recreational therapy in addition. All patients were evaluated with Functional Independence Measure (FIM) before and after treatment. ResultsThe scores of FIM significantly improved after treatment (P<0.05) in both groups, and the scores in social communication improved more (P<0.01) in recreational group than in control group. ConclusionRecreational therapy may improve the ability of social communication more effectively for stroke patients.
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We examined the effect of the liaison critical pathway for stroke among the inpatients in an acute hospital (AH) from 2007 to 2008. The average length of hospital stay in the AH was reduced by 5.7 days compared with 2006 by means of the critical pathway. Among 155 patients who had been transferred from the AH to a convalescent rehabilitation ward (CRW), 148 were discharged from the CRW. Ninety-seven patients returned home and 44 patients were transferred from the CRW to a nursing home type unit or an institution. One patient died in the CRW, six were returned to the AH. From among the clinical factors, that included sex, age, modified Rankin Scale (mRS), total, motor and cognitive scores of Functional independence measure (FIM) at discharge from the AH, total FIM scores and FIM gain at discharge from the CRW, mRS at discharge from the AH and total FIM scores at discharge from the CRW exerted an influence on outcome. Patients living with their spouses and / or children before the onset of stroke were more inclined to return home.
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At this Center, we directly interviewed 393 applicants for prostheses, orthotics, or other assistive devices in the last year and assessed their activities of daily living (ADL) using the functional independence measure (FIM). By investigating the relationship between the FIM scores and the prescription of prostheses, orthotics, or other assistive devices, we analyzed ADL in persons prescribed for assistive devices at a rehabilitation counseling center for persons with disabilities. This analysis revealed that there were some ADL patterns on the occasion of preparing medical writings and prescriptions. The FIM scores were totally good with upper or lower limb prostheses. In the case of computer based communication systems, there appeared a specific pattern wherein cognitive ratings except “expression” were good. Some patterns in ADL covering a combination of physical aspects and cognitive ones were found with the lower limb prostheses. ADL patterns were found to be overlapping among seating systems, wheelchairs and powered wheelchairs. Some patterns were seen in active usage for locomotion, some in usage with low physical and cognitive aspects, and others in different usages. From the viewpoint of ADL, some prescription grounds became clear, and it was shown that these grounds could be one of the guidelines used for the indication of assistive devices.
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@#Objective To investigate the effect of the rehabilitative therapy on functional recovery of patients with cervical cord injury.Methods 92 cases with spinal cord injury(SCI),including cervical,thoracic and lumbar cord injury,accepted normal rehabilitation.They were assessed with the Barthel Index and Functional Independence Measure(FIM)before and after treatment.Results After rehabilitation of 60~426 d,the scores of the Barthel Index and FIM were significantly improved(P<0.001)in all the patients,but it was the worst in the cervical cord injured ones,and the best in lumbar ones(P<0.05).Conclusion Rehabilitation can promote the functional recovery of patients with cervical spinal cord injury,but it is not as effective as on the thoracic and lumbar cord injury.
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To determine whether the clinical pathway in acute phase rehabilitation contributes to the early recovery of walking ability in elderly stroke patients, we developed a pathway for acute stroke patients over 65 years old who had lower extremity paresis. The pathway goal was to have patients walking within four weeks after the start of physiotherapy. We compared the improvement in walking ability during their stay in the stroke unit, length of stay and discharge destination between the two groups, namely the pre-pathway group that comprised 41 patients admitted before the introduction of the pathway and the post-pathway group that comprised 54 patients admitted after its introduction. In the post-pathway group, 68.5% of the patients achieved the goal, and the days required to achieve the goal were 9.6±6.0 days after the start of physiotherapy. The proportion of patients whose walking ability improved was significantly higher in the post-pathway group than the pre-pathway group (66.7% versus 39.0%, <i>p</i>=0.007). The efficiency of improvement was also higher in the post-pathway group (<i>p</i>=0.024). Logistic regression analysis showed that the use of the pathway was a factor that independently contributed to the improvement of walking ability (odds ratio, 2.80 ; 95% CI, 1.04 to 7.56 ; <i>p</i>=0.042). No significant differences were noted between the two groups in length of stay or discharge destination. From these results, it is suggested that the clinical pathway in acute phase rehabilitation promotes the recovery of walking ability in elderly stroke patients.