Abstract 2303: Therapeutic Intensity and Functional Gains of Stroke Patients during Inpatient Rehabilitation.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Hua Wang ◽  
Michelle Camicia ◽  
Joseph Terdiman ◽  
Murali K Mannava ◽  
M E Sandel
Keyword(s):  
Functional Outcomes ◽  
Inpatient Rehabilitation ◽  
Functional Improvement ◽  
Stroke Patients ◽  
Rehabilitation Therapy ◽  
The Mean ◽  
Total Therapy ◽  
Therapeutic Intensity ◽  
Functional Gain ◽  
Functional Gains

Objectives: To study the effects of therapeutic intensity on functional gains of stroke patients in inpatient rehabilitation. Design: A retrospective cohort study. Setting: An inpatient rehabilitation hospital (IRH) in northern California. Participants: Three hundred and sixty stroke patients discharged from the IRH in 2007. Interventions: Average number of minutes of rehabilitation therapy per day, including physical therapy (PT), occupation therapy (OT), speech language therapy (SLT), and total treatment. Main Outcome Measures: Functional gain measured by the Functional Independence Measure (FIM TM ), including activities of daily living (ADL), mobility, cognition, and total FIM TM scores. Results: The study sample had a mean age of 64.8 years (SD=13.8), and was 57.4% male, and 61.4% White. About three quarter of the patients had an ischemic stroke; 61.4% had one or more significant comorbid conditions. Median IRH length-of-stay (LOS) was 20 days. The mean total therapy time was 190.3 minutes per day (PT 114.0, OT 42.8, and SLT 33.8). The mean total functional gain was 26.0 (ADL 9.1, mobility 11.4, and cognition 6.2). A longer therapeutic duration per day was significantly associated with functional improvement (r=0.20, p<.001). However, patients who received total therapy time of less than 3 hours per day showed significantly lower total functional gain than those treated 3 hours or longer. There was no significant difference in total functional gain between patients treated 3-3.5 hours and over 3.5 hours per day. Intensity of PT, OT, and SLT in hours per day of treatment time was also significantly associated with corresponding sub-scale functional improvements. Figure 1 presents age and gender adjusted therapeutic intensity and FIM TM Gain. Multiple linear regression analyses showed that young age, hemorrhagic stroke, earlier admission to IRH, and longer IRH stay were independent predictors of functional improvement. Conclusions: The study demonstrated a significant relationship between therapeutic intensity and functional gain during IRH stay and provides evidence of treatment intensity thresholds for optimal functional outcomes for stroke patients in inpatient rehabilitation. Key Words: Stroke, rehabilitation therapy, intensity, functional outcomes.

Abstract TP146: Rate of Functional Improvement for Stroke Patients Plateaus During Inpatient Rehabilitation

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Shayandokht Taleb ◽  
Amy Durand ◽  
Melissa Huynh ◽  
Kaushik Parsha ◽  
Dorothea Parker ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Outcomes ◽  
Hemorrhagic Stroke ◽  
Polynomial Regression ◽  
Inpatient Rehabilitation ◽  
Functional Improvement ◽  
Stroke Patients ◽  
Improvement Rate ◽  
Score Improvement ◽  
Rehabilitation Facilities

Introduction: Functional outcomes and length of stay (LOS) are common outcome measures in stroke patients at Inpatient Rehabilitation Facilities (IRF). Aim: To examine trends in functional outcomes among patients with hemorrhagic versus ischemic stroke in IRF. Methods: Using a prospectively collected database of stroke patients admitted in our health system of 5 IRFs in Houston, we reviewed patients with either ischemic or hemorrhagic stroke between 1/18 to 6/19. The main outcome measure was the FIM scores. The relationship between LOS and FIM score improvement were analyzed using a third order polynomial regression model. Results: Among 88 patients, 43% were female and 60% had an ischemic stroke. The median LOS was 21 days (IQR14, 26) for all patients; 22 (IQR16, 30) in patients with hemorrhagic stroke; 20.5 (IQR14, 25) in patients with ischemic stroke (P: 0.24). Based on change in FIM, stroke patients benefited the most from IRF in the first 17 days (P<.0001) while the improvement rate declined significantly afterwards with the highest FIM score change of 32. The FIM score changes were not significantly different when adjusting for CMI. There were no significant differences in FIM changes and extent of temporal benefit between ischemic and hemorrhagic strokes. Moreover, bathing, dressing, tub transfer and walking were the areas of greatest improvement (Median change: 2 for all variables). Conclusion: Stroke patients in our IRF network benefit the most on FIM in the first 17 days. Further studies are needed to identify factors that could maximize functional gains in IRF.

Poster 99 The Effects of Pre-Morbid Anxiety and Depression on Functional Outcomes in Acute Stroke Patients Admitted to Inpatient Rehabilitation

PM&R ◽  
2015 ◽  
Vol 7 ◽  
pp. S123-S124
Author(s):  
David B. Essaff ◽  
Sarah Ackroyd ◽  
Kevin Rhie ◽  
Katarzyna B. Iwan ◽  
Jennifer Fleeman ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Functional Outcomes ◽  
Inpatient Rehabilitation ◽  
Anxiety And Depression ◽  
Stroke Patients

scholarly journals Dose-Response Effect of Daily Rehabilitation Time on Functional Gain in Stroke Patients

2020 ◽  
Vol 44 (2) ◽  
pp. 101-108
Author(s):  
Hanbit Ko ◽  
Howook Kim ◽  
Yeongwook Kim ◽  
Min Kyun Sohn ◽  
Sungju Jee
Keyword(s):  
Functional Outcomes ◽  
Treatment Time ◽  
Rehabilitation Medicine ◽  
Berg Balance Scale ◽  
Functional Change ◽  
Daily Treatment ◽  
Stroke Patients ◽  
Rehabilitation Treatment ◽  
Dose Response Effect ◽  
Functional Gain

Objective To demonstrate the effect of daily treatment time on recovery of functional outcomes and how each type of rehabilitation treatment influences the improvement of subgroups of functional outcomes in stroke patients.Methods We conducted a retrospective study in 168 patients who were admitted to the Department of Rehabilitation Medicine between 2015 and 2016. Patients who experienced their first-ever stroke and unilateral lesions were included. All patients underwent conventional rehabilitation treatment, and each treatment was administered one to two times a day depending on individual and treatment room schedules. Based on the mean daily treatment time, patients were divided into two groups: a high-amount group (n=54) and low-amount group (n=114). Outcomes were measured through the Korean version of Modified Barthel Index (MBI), FuglMeyer Assessment of the upper extremity, Trunk Impairment Scale (TIS), and Berg Balance Scale (BBS) scores on admission and at discharge.Results The functional change and scores at discharge of MBI, TIS, and BBS were greater in the high-amount group than in the low-amount group. Among various types of rehabilitation treatments, occupational therapy training showed significant correlation with MBI, TIS, and BBS gain from admission to discharge.Conclusion The amount of daily mean treatment in post-stroke patients plays an important role in recovery. Mean daily rehabilitation treatment time seems to correlate with improved balance and basic activities of daily living after stroke.

Poster 444: Time to Inpatient Rehabilitation Treatment and Functional Outcomes of Stroke Patients

PM&R ◽  
2010 ◽  
Vol 2 ◽  
pp. S193-S193
Author(s):  
Hua Wang ◽  
Michelle Camicia ◽  
Yunyi Hung ◽  
Joe Terdiman
Keyword(s):  
Functional Outcomes ◽  
Inpatient Rehabilitation ◽  
Stroke Patients ◽  
Rehabilitation Treatment

scholarly journals The Effect of Prolonged Inpatient Rehabilitation Therapy in Subacute Stroke Patients

2012 ◽  
Vol 36 (1) ◽  
pp. 16 ◽  
Author(s):  
Jong Hwa Lee ◽  
Sang Beom Kim ◽  
Kyeong Woo Lee ◽  
Ji Yeong Lee
Keyword(s):  
Inpatient Rehabilitation ◽  
Stroke Patients ◽  
Rehabilitation Therapy ◽  
Subacute Stroke

scholarly journals Clinical and functional outcomes of Lambrinudi arthrodesis for correcting fixed equinus deformity

2018 ◽  
Vol 12 (2) ◽  
pp. 159-163
Author(s):  
José Antônio Ribeiro Muniz Filho ◽  
Cleber Jesus Pereira ◽  
Eduardo Gomes Espinosa ◽  
Flávio Malagoli Buiatti ◽  
Rafael Teixeira Fernandes ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Functional Outcomes ◽  
Case Series ◽  
Functional Improvement ◽  
Level Of Evidence ◽  
Charcot Marie Tooth Disease ◽  
Significant Correction ◽  
The Mean ◽  
Equinus Deformity ◽  
The Difference

Objective: To evaluate the clinical and functional outcomes of correction of fixed equinus deformity by Lambrinudi arthrodesis. Methods: Eight patients with fixed equinus deformity were retrospectively assessed. Of these patients, three cases developed secondary to Charcot-Marie-Tooth disease, and five cases developed secondary to fibular nerve injury following trauma. All patients underwent Lambrinudi arthrodesis using the open technique, and functional improvement was analysed postoperatively. The mean age of the patients was 27 years and six months, and six patients were men. Results: The results were evaluated using the ankle and hindfoot score of the American Orthopedic Foot and Ankle Society (AOFAS) scale. The mean score in the postoperative period was 61.71 points, ranging from 41 to 74 points. The difference in the tibia-ground angle in the pre- and postoperative period was measured, and there was a significant correction of this angle. Conclusion: The outcomes of Lambrinudi arthrodesis in patients with fixed equinus deformity were satisfactory concerning the improvement of pain, gait, a high degree of correction of the deformity according to the difference in the tibia-ground angle between the pre- and postoperative period, and preservation of the ankle joint. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals A Pilot Project of Early Integrated Traumatic Brain Injury Rehabilitation in Singapore

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Siew Kwaon Lui ◽  
Yee Sien Ng ◽  
Annie Jane Nalanga ◽  
Yeow Leng Tan ◽  
Chek Wai Bok
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Outcomes ◽  
Inpatient Rehabilitation ◽  
Epidemiological Data ◽  
Pilot Project ◽  
Functional Improvement ◽  
Early Screening ◽  
Neurosurgical Department ◽  
Rehabilitation Team

Objective.Document acute neurosurgical and rehabilitation parameters of patients of all traumatic brain injury (TBI) severities and determine whether early screening along with very early integrated TBI rehabilitation changes functional outcomes.Methods. Prospective study involving all patients with TBI admitted to a neurosurgical department of a tertiary hospital. They were assessed within 72 hours of admission by the rehabilitation team and received twice weekly rehabilitation reviews. Patients with further rehabilitation needs were then transferred to the attached acute inpatient TBI rehabilitation unit (TREATS) and their functional outcomes were compared against a historical group of patients. Demographic variables, acute neurosurgical characteristics, medical complications, and rehabilitation outcomes were recorded.Results.There were 298 patients screened with an average age of61.8±19.1years. The most common etiology was falls (77.5%). Most patients were discharged home directly (67.4%) and 22.8% of patients were in TREATS. The TREATS group functionally improved (P<0.001). Regression analysis showed by the intervention of TREATS, that there was a statistically significant FIM functional gain of 18.445 points (95% CI −30.388 to −0.6502,P=0.03).Conclusion.Our study demonstrated important epidemiological data on an unselected cohort of patients with TBI in Singapore and functional improvement in patients who further received inpatient rehabilitation.

Poster 53 Therapeutic Intensity and Functional Gains During Inpatient Rehabilitation

PM&R ◽  
2011 ◽  
Vol 3 ◽  
pp. S195-S195
Author(s):  
Hua Wang ◽  
Michelle Camicia ◽  
Murali K. Mannava ◽  
Elizabeth Sandel ◽  
Steve Sidney ◽  
...  
Keyword(s):  
Inpatient Rehabilitation ◽  
Therapeutic Intensity ◽  
Functional Gains

scholarly journals Evaluation of sensorimotor reactions during early rehabilitation for patients after cerebral stroke

Medicina ◽  
2007 ◽  
Vol 43 (12) ◽  
pp. 942
Author(s):  
Daiva Petruševičienė ◽  
Raimondas Savickas ◽  
Aleksandras Kriščiūnas
Keyword(s):  
Early Stage ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Early Rehabilitation ◽  
Point Of View ◽  
Functional Improvement ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Functional Changes

Early inpatient rehabilitation is extremely important in functional improvement of patients suffering from cerebral stroke. From our point of view, in rehabilitation of patients after cerebral stroke, the estimation of sensorimotor reactions that enables the evaluation of sensorimotor functional changes is highly relevant. The article describes the comparison of sensorimotor reactions in two subgroups – stroke patients and healthy individuals – by applying Sensoneck system. The evaluation was performed before early stage of rehabilitation and thereafter (following early rehabilitation). In order to estimate the correlation between changes in functional independence and sensorimotor reactions, Functional Independence Measure was used. The study revealed that stroke patients had sensorimotor dysfunctions. During early rehabilitation, the quality of motion performance improved slightly, and sensorimotor reactions improved statistically significantly (P<0.05). The relationship between Functional Independence Measure and Sensoneck scores was not significant (P>0.05).

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