{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:24Z","timestamp":1789013304868,"version":"build-2803163510"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Trends in functional recovery after ischemic stroke within inpatient rehabilitation settings are not well\u2010described. This study evaluated 18\u2010year trends in functional motor improvement among adults receiving inpatient rehabilitation for ischemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We conducted a retrospective cohort study of adults with ischemic stroke admitted to a large rehabilitation system from December 2001 to September 2019. The primary outcome was the attainment of a minimal clinically important difference (MCID) in the Functional Independence Measure Motor score, defined as a \u226520\u2010point increase in Functional Independence Measure Motor score. Multivariable logistic regression was used to evaluate temporal trends and their interaction with insurance. Sensitivity analyses evaluated changes in case\u2010mix index, Charlson Comorbidity Index, and length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 9809 ischemic stroke rehabilitation admissions representing 9126 unique patients, 4445 (45.3%) admissions attained MCID. The adjusted odds of MCID attainment increased annually (odds ratio, 1.085 [95% CI, 1.067\u20131.104]). Model\u2010based predicted probabilities for MCID attainment increased from 0.239 (95% CI, 0.192\u20130.286) in 2001 to 0.555 (95% CI, 0.509\u20130.601) in 2019 for Medicare Fee\u2010for\u2010Service and from 0.345 (95% CI, 0.307\u20130.383) to 0.564 (95% CI, 0.530\u20130.598) for non\u2010Medicare patients. The year\u2010by\u2010insurance interaction was significant, indicating smaller annual gains for non\u2010Medicare patients (odds ratio, 0.973 [95% CI, 0.953\u20130.993];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.007). The case\u2010mix index showed no temporal change, while the Charlson Comorbidity Index increased and length of stay declined over time. However, neither the Charlson Comorbidity Index, case\u2010mix index, nor rehabilitation duration explains the temporal improvement in MCID attainment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Functional motor recovery improved substantially over 18\u2009years, independent of patient complexity and comorbidity burden, establishing contemporary benchmarks for inpatient stroke rehabilitation outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048437","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T10:18:20Z","timestamp":1784974700000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Eighteen\u2010Year Trends in Motor Recovery During Inpatient Rehabilitation After Ischemic Stroke"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1584-8114","authenticated-orcid":false,"given":"Abdulaziz","family":"Bako","sequence":"first","affiliation":[{"name":"TIRR Memorial Hermann","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman","family":"Khan","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5605-7632","authenticated-orcid":false,"given":"Elizabeth","family":"Larkin","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Baig","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4709-545X","authenticated-orcid":false,"given":"Shannon B.","family":"Juengst","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann","place":["Houston, USA"]},{"name":"UT Health Houston","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7494-0298","authenticated-orcid":false,"given":"Angelle M.","family":"Sander","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3464-2111","authenticated-orcid":false,"given":"Farhaan S.","family":"Vahidy","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001209"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02251-x"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000098"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90184-7"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007392"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9993(93)90119-U"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.3109\/09638289509166622"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2005.08.130"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2023.2175386"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1569186120979428"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.1204"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.044263"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-023-01371-7"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2022.01.034"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135834"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90130-6"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.14.1687"},{"key":"e_1_3_1_19_2","unstructured":"IRF\u2010PAI training manual. 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