scholarly journals Association Between Facility Type During Pediatric Inpatient Rehabilitation and Functional Outcomes

2016 ◽  
Vol 97 (9) ◽  
pp. 1407-1412.e1 ◽  
Author(s):  
Molly M. Fuentes ◽  
Susan Apkon ◽  
Nathalia Jimenez ◽  
Frederick P. Rivara
2018 ◽  
Vol 99 (10) ◽  
pp. e67
Author(s):  
Mili Vakharia ◽  
Christian M. Niedzwecki ◽  
Daniel Curry ◽  
Aloysia Schwabe ◽  
Kristen Staggers

Author(s):  
Gurumayum Sonachand Sharma ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Naveen Bangarpet Prakash

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.


PM&R ◽  
2015 ◽  
Vol 7 ◽  
pp. S123-S124
Author(s):  
David B. Essaff ◽  
Sarah Ackroyd ◽  
Kevin Rhie ◽  
Katarzyna B. Iwan ◽  
Jennifer Fleeman ◽  
...  

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Hua Wang ◽  
Michelle Camicia ◽  
Joseph Terdiman ◽  
Murali K Mannava ◽  
M E Sandel

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.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
James J García ◽  
Karlita L Warren ◽  
Fengmei Gong ◽  
Honggang Wang

Introduction: Stroke is one of the leading cause of disability and death in the United States (Benjamin et al., 2018). Inpatient rehabilitation is the gold standard treatment for post-acute care (Weinstein et al., 2016). Data indicate a discharge to inpatient rehabilitation facilities (IRFs) following the acute stroke phase has increased (Buntin, Colla, & Escarce, 2009). The inpatient milieu provides a unique opportunity to examine predictors of functional outcomes using a captive sample. Thus, the current study aim is to identify factors associated with poststroke functional outcomes throughout inpatient rehabilitation. Method: This is a cross-sectional and retrospective analysis of data extracted from an administrative database during years 2005-2016 from 244,286 stroke patients across 30% of IRFs in the U.S. Inclusion criteria were patients at or above the age 18 with stroke as an admitting diagnosis using ICD 9/10 codes 430-438/I60-I69. Dependent variables were: admission Total FIM, Total FIM efficiency, discharge Total FIM, and length of stay (LOS). Results: Using separate regression analyses, marital status, admit year, type of admission, race/ethnicity, insurance type, sex, age, number of complications, number of comorbidities, and stroke type, emerged as significant predictors of functional outcomes throughout inpatient rehabilitation. Moreover, those with greater comorbidities and complications were associated with lower admission FIM total score, less total FIM efficiency, lower discharge FIM total score, and a longer LOS. Compared to NHWs, racial/ethnic people were associated with lower FIM scores throughout inpatient rehabilitation and a longer length of stay. Discussion: In this robust national dataset, data indicate clinical and sociodemographic factors are significantly associated with poststroke functional outcomes throughout inpatient rehabilitation. Implications are discussed within a framework of social determinants of health.


2018 ◽  
Vol 99 (10) ◽  
pp. e85-e86
Author(s):  
Librada Callender ◽  
Anne Woolsey ◽  
Lacy McDonald ◽  
Nam Nguyen ◽  
Monica Bennett ◽  
...  

2009 ◽  
Vol 72 (5) ◽  
pp. 219-225 ◽  
Author(s):  
Maria Stella Stein ◽  
David Maskill ◽  
Louise Marston

This study evaluated basic functional mobility in 25 patients with stroke and visual-spatial neglect during inpatient rehabilitation and early follow-up. Seven patients with neglect and 12 patients without neglect were discharged home and the rest to institutions. Patients without neglect achieved higher outcomes in a shorter time (mean 52 and 79 days respectively). All patients discharged home continued to improve at least up to 5 weeks post-discharge. The patients discharged to institutions achieved lower outcomes overall and quickly deteriorated to admission levels post-discharge. The results inform occupational therapy practice in the areas of assessment, discharge planning, destination and expected functional mobility outcomes in the community.


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