Functional Changes and Home Discharge After Inpatient Stroke Rehabilitation

Association Between Changes in Integrated Rehabilitation Functional Assessment and Discharge Destination in Patients With Stroke in a Post-Acute Rehabilitation Hospital: A Retrospective EMR-Based Observational Study

This retrospective observational study will evaluate whether changes in functional status during inpatient rehabilitation are associated with discharge destination in patients with stroke treated at a post-acute rehabilitation hospital. The study will use de-identified electronic medical record data from adult patients with stroke who were admitted to Zenith Hospital and discharged between January 1, 2024 and March 31, 2025.

Integrated rehabilitation functional assessment data obtained at admission and discharge will be analyzed, including the Korean Modified Barthel Index (K-MBI), Functional Ambulation Category (FAC), Berg Balance Scale (BBS), Mini-Mental State Examination (MMSE), and Manual Function Test (MFT). The main objective is to determine whether changes in these measures during hospitalization are associated with discharge destination, defined as home discharge versus transfer to another institution.

Approximately 150 eligible patients are expected to be included. Only existing de-identified EMR data will be used. No direct participant contact, additional data collection, or protocol-assigned intervention will occur. Findings from this study may provide evidence to support discharge planning and community reintegration strategies for patients with stroke receiving post-acute rehabilitation.

Study Overview

• Status: Completed
• Conditions: Stroke; Cerebrovascular Disease
• Intervention / Treatment: Other: Inpatient Rehabilitation

Detailed Description

Stroke is a major cause of disability, and discharge destination after inpatient rehabilitation is an important clinical and social outcome. In post-acute rehabilitation settings, integrated functional assessments are routinely performed during hospitalization, but there is limited evidence on whether the magnitude of functional improvement between admission and discharge is associated with home discharge among patients with stroke in Korean rehabilitation hospitals. This study is designed to address that gap using de-identified electronic medical record data from a post-acute rehabilitation hospital.

The primary purpose of this study is to investigate the association between changes in integrated rehabilitation functional assessment scores during hospitalization and discharge destination in patients with stroke. Specifically, the study will evaluate whether changes in Korean Modified Barthel Index (K-MBI), Functional Ambulation Category (FAC), Berg Balance Scale (BBS), Mini-Mental State Examination (MMSE), and Manual Function Test (MFT) are associated with home discharge versus transfer to another institution.

This is a retrospective observational study conducted at Zenith Hospital, a post-acute rehabilitation hospital in the Republic of Korea. The study population will include adult patients with stroke who were admitted to the rehabilitation ward and discharged between January 1, 2024 and March 31, 2025. Eligible participants must have integrated rehabilitation functional assessment data recorded in the electronic medical record at both admission and discharge. Patients with missing admission or discharge functional assessment data, terminal illness preventing rehabilitation, in-hospital death, or insufficient EMR data for analysis will be excluded.

The main independent variables are changes in functional assessment scores between admission and discharge, including delta K-MBI, delta FAC, delta BBS, delta MMSE, and delta MFT. The primary outcome is discharge destination, categorized as home discharge or transfer to another institution. Covariates available in the EMR, such as age, sex, length of stay, and stroke type, will also be analyzed as potential confounders.

The study procedures are as follows: the hospital medical records team will identify potentially eligible patients according to the inclusion and exclusion criteria; all direct identifiers will be removed from the EMR data; a study-specific de-identified code will be assigned; and only de-identified data will be provided to the investigator for analysis. The investigator will calculate functional changes and perform statistical analyses to identify factors associated with discharge destination. There will be no participant contact, no prospective enrollment, no survey administration, and no intervention assigned as part of this study.

The study has been reviewed and approved by the Public Institutional Bioethics Committee No. 1 designated by the Ministry of Health and Welfare (Approval No. P01-202512-01-054). The findings are expected to provide practical evidence for discharge planning, patient stratification, and community reintegration support in post-acute stroke rehabilitation.

• Study Type: Observational
• Enrollment (Actual): 150

Contacts and Locations

Study Locations

• South Korea
  • Seoul, South Korea
    • Zenith Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Adult patients with stroke who were admitted to the post-acute rehabilitation ward at Zenith Hospital and discharged between January 1, 2024 and March 31, 2025, with de-identified electronic medical record data available for integrated rehabilitation functional assessments at both admission and discharge.

Description

Inclusion Criteria:

• Adults aged 19 years or older
• Patients with stroke who were admitted to and discharged from the post-acute rehabilitation ward at Zenith Hospital between January 1, 2024 and March 31, 2025
• Patients with integrated rehabilitation functional assessment data recorded in the electronic medical record at both admission and discharge, including Korean Modified Barthel Index (K-MBI), Functional Ambulation Category (FAC), Berg Balance Scale (BBS), Mini-Mental State Examination (MMSE), and Manual Function Test (MFT)

Exclusion Criteria:

• Missing admission or discharge functional assessment data
• Patients with terminal illnesses that made rehabilitation treatment infeasible, such as advanced cancer or end-stage heart failure
• In-hospital death or transfer before discharge assessment, resulting in no discharge functional assessment data
• Insufficient electronic medical record data for the study analysis

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Home Discharge; Patients with stroke who were discharged to home after inpatient rehabilitation.	Other: Inpatient Rehabilitation; Usual inpatient rehabilitation received during admission as part of routine clinical care. No intervention was assigned by the study protocol.
Transfer to Another Institution; Patients with stroke who were transferred to another institution after inpatient rehabilitation.	Other: Inpatient Rehabilitation; Usual inpatient rehabilitation received during admission as part of routine clinical care. No intervention was assigned by the study protocol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Discharge Destination	Discharge destination assessed at discharge from inpatient rehabilitation, categorized as home discharge or transfer to another institution.	At discharge from inpatient rehabilitation, up to 15 months after admission

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Korean Modified Barthel Index (K-MBI) score	Change in Korean Modified Barthel Index score from admission to discharge. The Korean Modified Barthel Index is a measure of activities of daily living with scores ranging from 0 to 100, where higher scores indicate greater independence.	From admission to discharge from inpatient rehabilitation, up to 15 months
Change in Functional Ambulation Category (FAC) score	Change in Functional Ambulation Category score from admission to discharge. The Functional Ambulation Category is a measure of walking ability with scores ranging from 0 to 5, where higher scores indicate better ambulation.	From admission to discharge from inpatient rehabilitation, up to 15 months
Change in Berg Balance Scale (BBS) score	Change in Mini-Mental State Examination score from admission to discharge. The Mini-Mental State Examination is a measure of cognitive function with scores ranging from 0 to 30, where higher scores indicate better cognitive function.	From admission to discharge from inpatient rehabilitation, up to 15 months
Change in Mini-Mental State Examination (MMSE) score	Change in Mini-Mental State Examination score from admission to discharge. The MMSE is a measure of cognitive function with scores ranging from 0 to 30, where higher scores indicate better cognitive status.	From admission to discharge from inpatient rehabilitation, up to 15 months
Change in Manual Function Test (MFT) score	Change in Manual Function Test score from admission to discharge. The Manual Function Test is a measure of upper extremity motor function with scores ranging from 0 to 32, where higher scores indicate better upper extremity function.	From admission to discharge from inpatient rehabilitation, up to 15 months

Collaborators and Investigators

• Sponsor: SeongKi Min

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2024
• Primary Completion (Actual): March 31, 2025
• Study Completion (Actual): March 31, 2025

Study Registration Dates

• First Submitted: March 8, 2026
• First Submitted That Met QC Criteria: March 25, 2026
• First Posted (Actual): March 31, 2026

Study Record Updates

• Last Update Posted (Actual): April 3, 2026
• Last Update Submitted That Met QC Criteria: March 30, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Electronic Medical Record; Functional Recovery; Mini-Mental State Examination; Berg Balance Scale; Home Discharge; Functional Ambulation Category; Post-Acute Rehabilitation; Discharge Destination; Korean Modified Barthel Index; Manual Function Test
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke; Cerebrovascular Disorders
• Other Study ID Numbers: P01-202512-01-054

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared because this retrospective study uses de-identified electronic medical record data collected at a single institution, and data sharing is restricted by institutional policy and ethics requirements to protect participant privacy and confidentiality.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No