Daily Treatment Time and Functional Gains of Stroke Patients During Inpatient Rehabilitation

PM&R ◽  
2012 ◽  
Vol 5 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Hua Wang ◽  
Michelle Camicia ◽  
Joseph Terdiman ◽  
Murali K. Mannava ◽  
Stephen Sidney ◽  
...  
Keyword(s):  
Treatment Time ◽  
Inpatient Rehabilitation ◽  
Daily Treatment ◽  
Stroke Patients ◽  
Functional Gains

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.

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.

The obesity paradox may not lead to functional gains in stroke patients undergoing acute inpatient rehabilitation

PM&R ◽  
2021 ◽  
Author(s):  
Casey Freeman ◽  
Allison Blough ◽  
Duncan Rotich ◽  
Amanda Curl ◽  
Sarah M. Eickmeyer
Keyword(s):  
Inpatient Rehabilitation ◽  
Obesity Paradox ◽  
Stroke Patients ◽  
Functional Gains

Fall-related injuries in anticoagulated stroke patients during inpatient rehabilitation

1995 ◽  
Vol 76 (9) ◽  
pp. 840-843 ◽  
Author(s):  
Joel Stein ◽  
Blanca E. Viramontes ◽  
D. Casey Kerrigan
Keyword(s):  
Inpatient Rehabilitation ◽  
Stroke Patients

Abstract T P243: Mortality Among Transferred Hemorrhagic Stroke Patients in United States: An Analysis From National Database

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Malik M Adil ◽  
Shyam Prabhakaran
Keyword(s):  
Hospital Mortality ◽  
Hemorrhagic Stroke ◽  
Inpatient Rehabilitation ◽  
National Database ◽  
Stroke Patients ◽  
Discharge Outcomes ◽  
Hospital Transfer ◽  
Transferred Patients ◽  
Surgical Treatments ◽  
Acute Rehabilitation

Background: Hemorrhagic stroke patients may require inter-facility transfer for higher level of care. Limited data are available on outcome of transferred patients. Objective: To determine in-hospital mortality and discharge outcomes among transferred hemorrhagic stroke patients. Methods: Data from all patients admitted to US hospitals between 2008 and 2011 with a primary discharge diagnosis of hemorrhagic stroke [intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH)] were identified by ICD-9 codes (ICH: 431; SAH: 430). In separate models for ICH and SAH using logistic regression, the odds ratio (OR) and 95% confidence intervals (CI) for in-hospital mortality and good outcome (discharge home or inpatient rehabilitation) among transfer vs. non-transfers were estimated, after adjusting for potential confounders. Results: Of 290,395 patients with ICH, 48,749 (16.8%) arrived by inter-hospital transfer; for SAH, 25,726 (33%) of 78,156 were transfers. In-hospital mortality was lower among ICH transfers (21.2% vs. 23.2%; p=0.004). In adjusted analyses, in-hospital mortality was not significantly different (p=0.20) while discharge to home or inpatient rehabilitation was more likely among transferred ICH patients (OR 1.1, 95% CI 1.0-1.2, p=0.05). In-hospital mortality was lower for SAH transfers (17.4% vs. 22.9%, p<0.001) and remained significant in adjusted analyses (OR 0.7, 95% CI 0.6-0.8). Transferred SAH patients were also more likely to be discharged to home or inpatient rehabilitation (OR 1.2, 95% CI 1.1-1.4, p<0.001). Coiling and clipping procedures were significantly more common in SAH transferred patients while cerebral angiography, mechanical ventilation and gastrostomy were significantly higher in both ICH and SAH transfer patients. Conclusion: While ICH patients arriving by transfer have similar mortality as non-transfers, they are more likely to be discharged to home or acute rehabilitation. For SAH, transfer confers both mortality and outcome benefit. Definitive surgical treatments and aggressive medical supportive care at receiving hospitals may mediate the benefits of inter-hospital transfer in hemorrhagic stroke patients.

Older Adult Stroke Patients and Their Spousal Caregivers

1994 ◽  
Vol 75 (10) ◽  
pp. 608-615 ◽  
Author(s):  
Janice K. Purk ◽  
Rhoda A. Richardson
Keyword(s):  
Older Adult ◽  
Emotional Functioning ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Spousal Caregivers ◽  
Stroke Patients

Using a sample of 44 couples, in each of which one member had suffered a stroke requiring an inpatient rehabilitation stay, the authors examined the morale of stroke patients older than 60 and their spousal caregivers. One hypothesis that guided this research was that the morale levels of older adult stroke patients would correlate with those of their spousal caregivers and with the patient's physical and emotional functioning. Gender and length of time since the stroke were hypothesized to have an effect on morale. Results indicated that morale of caregivers and care receivers were positively correlated. Moreover, functional independence predicted patient and spouse morale levels. Impressions of caregiving and morale of caregivers were correlated. These findings suggest a need to utilize a dyadic approach in research and intervention dealing with stroke patients whose spouses are providing care.

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
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