Stroke Rehabilitation Fact Sheet in Korea

Abstract

With rapid aging, the number of stroke survivors with disabilities in Korea is increasing even if mortality is declining. Despite coordinated efforts for quality improvement of stroke rehabilitation in Korea, the statistics of stroke rehabilitation were not well reported. This review aimed to provide contemporary and comprehensive statistics and recent changes in stroke rehabilitation in Korea. The Clinical Practice Guideline for Stroke Rehabilitation in Korea was developed in 2009 and updated in 2012 and 2016. Additionally, the representative databases for stroke rehabilitation include the Korean Brain Rehabilitation Database and the Korean Stroke Cohort for functioning and rehabilitation. These nationwide databases provided current information on stroke rehabilitation. Among Korean stroke survivors, one in three had motor impairment, one in four had cognitive impairment, one in three had speech impairment, one in four was dependent in ambulation, one in six had swallowing difficulty, and one in four was dependent in activities in daily living at 5 years after stroke. Comprehensive inpatient rehabilitation following transfer to the department of rehabilitation medicine significantly decreased stroke-related mortality and long-term disability. This review provides an improved understanding of stroke rehabilitation and guidance to implement timely, coordinated, evidence-based stroke rehabilitation services to relieve the socioeconomic burden of stroke.

Keywords: Disability; Rehabilitation; Statistics; Stroke.

Fig. 1.

Stroke mortality in Korea (2010–2019).

Fig. 2.

Annual medical cost per person in 15 categories of disability in Korea (2018). Adapted from the National Rehabilitation Center [5]. KRW, Korean won.

Fig. 3.

Survival curve after first-ever stroke according to transfer to the Department of Rehabilitation Medicine. Adapted from the National Institute of Health [12].

Fig. 4.

Five-year post-stroke functional changes in the first cohort of the Korean Stroke Cohort for functioning and rehabilitation (KOSCO): (A) K-MBI (ADL), (B) FMA (motor recovery), (C) K-MMSE (cognition), (D) FAC (ambulation), (E) ASHA-NOMS (swallowing), (F) Short K-FAST (speech). Adapted from the National Institute of Health [12]. K-MBI, Korean version of Modified Barthel Index; ADL, activities of daily living; FMA, Fugl-Meyer Assessment; K-MMSE, Korean version of Mini-Mental State Examination; FAC, Functional Ambulation Category; ASHA-NOMS, Association National Outcome Measurement System Swallowing Scale; K-FAST, Korean version of Frenchay Aphasia Screening Test.

Fig. 5.

Comparison of age distributions for first-ever stroke between the first and second cohorts of the Korean Stroke Cohort for functioning and rehabilitation (KOSCO). Adapted from the National Institute of Health [12].