A Comparison of Characteristics of Patients with Completed Stroke: Those Who Achieve Continence and Those Who Do Not

Abstract

The purpose of this retrospective study was to compare the demographic, neurologic, and cognitive characteristics of patients with completed stroke who participated in a behavioral management program for urinary incontinence. The study sought to determine the differences between those patients who achieved continence by the time of discharge from the program and those who did not. A retrospective chart review that used the Functional Independence Measure (FIM) scores identified 75 subjects with urinary incontinence at the time of admission. Forty-two study subjects achieved continence after participating in a rehabilitation and bladder management program. Thirty-three study subjects remained incontinent despite participation in a rehabilitation and bladder management program. Incontinent subjects had more difficulty with orientation to time, memory, and problem solving. These areas of cognitive function appear to have a direct impact on the ability of the person with stroke to achieve continence.

A Comparison of the Characteristics of Incontinent and Continent Stroke Patients in a Rehabilitation Program

“…The patients in this study reflected an association between UI and poorer poststroke outcomes identified in previous research (Gelberet al, 1993; Jongbloed, 1986; Owen et al, 1995). The subjects for whom UI persisted throughout their rehabilitation program exhibited lower functional status scores at discharge and made less improvement during rehabilitation.…”

“…This study extends the work of Owen et al (1995) by comparing outcomes measured at set intervals from the time of stroke onset. In addition, this study describes and compares patients’ progress in rehabilitation based on their continence status at discharge.…”

“…Half of the 90 patients who were incontinent at admission regained continence by discharge. Other investigators reported return‐to‐continence rates by the time of discharge ranging from 56% (Owen et al, 1995) to 66% (Reding et al, 1987). Continence status did not influence discharge location after rehabilitation, but the long‐term consequences of incontinence on care and subsequent placements were not addressed.…”

“…Owen, Getz, and Bulla (1995) reported the findings of a retrospective chart audit to compare the characteristics of incontinent stroke patients who achieved continence with those who did not by the time of their discharge from rehabilitation. Of 75 patients who were incontinent at admission and met inclusion criteria, 39 (52%) achieved continence after a rehabilitation and bladder management program.…”

Family Health and Functional Outcomes in Rehabilitation

“…Much has been written about functional outcomes in rehabilitation (Chae, Zorowitz, & Johnston, 1996; Cook, Smith, & Truman, 1994; Frost & Barone, 1996; Goldstein, Strasser, Woodard, & Roberts, 1997; Hanks & Lichtenberg, 1996; Hinkle & Forbes, 1996; Owen, Getz, & Bulla, 1995; Stineman, Maislin, Fiedler, & Granger, 1997; Ween, Alexander, D'Esposito, & Roberts, 1996). Jaworski, Kult, and Boynton (1994) report that “a functional assessment tool is commonly used to establish a patient's baseline functional level and to evaluate whether rehabilitation outcomes have been attained during rehabilitation” (p. 141).…”