Functional significance of the subcortical vascular syndrome in the rehabilitative setting

The purpose of this study was to examine the effect of cortical versus subcortical and right versus left hemispheric vascular lesion site on rehabilitative functional status. Seventy patients were prospectively studied. A 2 x 2 ANOVA showed significant group differences with the cortical group being more impaired on both the initial admission and discharge Functional Independence Measure (FIM) scores (F = 14.2, p < .0004 and F = 12.2, p < .0009, respectively). Analysis of the component FIM profile showed that the cortical group was relatively more impaired on measures of self-care, language, and social cognition, but not sphincter control or ambulation status. This general pattern also was similar at discharge with the exception of self-care. Left hemispheric lesion site was a strong predictor of language-related deficits. In addition, a Chi-square analysis showed that the cortical group had a greater frequency of unsafe behaviors requiring physical restraints. The implication of cortical versus subcortical lesion site was discussed relative to rehabilitative treatment planning.