Impact of Early Multimodal Rehabilitation (± Task-Oriented Therapy) → Δ Functional Independence Measure (FIM) And Muscle Strength (↑ MRC Score) In Post-Stroke Patients

Abstract

Background: Stroke remains a leading cause of long-term disability. Early multimodal rehabilitation with or without task-oriented therapy may improve post-stroke independence and muscle strength outcomes. Objective: To evaluate the effect of early multimodal rehabilitation (± task-oriented therapy) on ΔFunctional Independence Measure (FIM) and ↑Medical Research Council (MRC) muscle strength scores in post-stroke patients. Methods: This prospective cohort study enrolled 122 post-stroke patients admitted to the Department of Physical Medicine & Rehabilitation, Rajshahi Medical College Hospital, from January–June 2023. Patients received early multimodal rehabilitation, stratified into two arms: with (n=62) or without (n=60) structured task-oriented therapy. Outcomes included FIM, MRC scores, Barthel Index, Timed Up-and-Go (TUG), and Modified Rankin Scale (mRS). Data were analyzed using paired t-tests, ANOVA, and regression modeling; p<0.05 was significant. Results: At baseline, mean FIM was 58.3±7.2, and mean MRC was 2.1±0.6. After 12 weeks, FIM improved to 92.7±8.4 in the task-oriented group (Δ+34.4, 59.0% gain, p<0.001) versus 82.9±7.6 in controls (Δ+24.6, 42.2% gain, p<0.01). MRC increased to 4.1±0.8 (task-oriented) compared with 3.4±0.7 (non-task-oriented), yielding a mean Δ+2.0 vs. Δ+1.3, respectively (p=0.002). Secondary measures: Barthel Index improved by 45.8±6.3 vs. 31.6±5.9 (p<0.001); mean TUG time decreased by 11.4±3.2 seconds vs. 7.6±2.8 (p=0.004). Regression analysis identified task-oriented therapy as an independent predictor of ΔFIM (β=0.42, CI 0.28–0.61) and ΔMRC (β=0.31, CI 0.18–0.54). Effect size (Cohen’s d) for FIM gain was 1.12. Conclusion: Early multimodal rehabilitation significantly enhances independence and muscle strength, with task-oriented therapy conferring superior functional recovery. These findings support incorporating structured task-specific interventions into standard rehabilitation.