Predicting prosthetic rehabilitation outcome in lower limb amputee patients with the functional independence measure

1996 ◽  
Vol 77 (6) ◽  
pp. 605-608 ◽  
Author(s):  
Eric Chung-Ching Leung ◽  
Perry Joel Rush ◽  
Michael Devlin
Keyword(s):  
Lower Limb ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Prosthetic Rehabilitation ◽  
Rehabilitation Outcome ◽  
Lower Limb Amputee

scholarly journals Relationship between upper limb motor function and activities of daily living after removing the influence of lower limb motor function in subacute patients with stroke: A cross-sectional study

2020 ◽  
pp. 156918612092660
Author(s):  
Haruka Yamamoto ◽  
Kazuya Takeda ◽  
Soichiro Koyama ◽  
Keisuke Morishima ◽  
Yuichi Hirakawa ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Daily Living ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Score ◽  
Cross Sectional ◽  
The Relationship

Background Previous studies have reported a relationship between upper limb motor function and activities of daily living. However, their relationship after removing the influence of lower limb motor function has not been clarified. Objective This study aimed to investigate the relationship between Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score and between Fugl-Meyer assessment upper limb and each item contained in Functional Independence Measure motor score after eliminating the influence of the motor function of the affected lower limb. Methods This retrospective cross-sectional study included 58 subacute stroke patients. To investigate the relationship between the Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score before and after removing the influence of Fugl-Meyer assessment lower limb, Spearman’s rank correlation coefficient and partial correlation analysis were used. Additionally, the relationship between Fugl-Meyer assessment upper limb and each item of Functional Independence Measure motor score after removing the influence was assessed. Results Before removing the influence of Fugl-Meyer assessment lower limb, Fugl-Meyer assessment upper limb was strongly correlated with total Functional Independence Measure motor score (r = 0.74, p < 0.001). However, it became weak after removing the influence (r = 0.27, p = 0.04). Regarding each item of Functional Independence Measure motor score, Fugl-Meyer assessment upper limb was correlated with grooming (r = 0.27, p = 0.04), bathing (r = 0.28, p = 0.03), dressing upper body (r = 0.33, p = 0.01), dressing lower body (r = 0.31, p = 0.02), and stair-climbing (r = 0.31, p = 0.02) after removing the influence. Conclusion These findings suggest that the relationship between the upper limb motor function and activities of daily living is strongly influenced by lower limb motor function.

Multiple sclerosis: a preliminary study of selected variables affecting rehabilitation outcome

1999 ◽  
Vol 5 (2) ◽  
pp. 94-100 ◽  
Author(s):  
D W Langdon ◽  
A J Thompson
Keyword(s):  
Multiple Sclerosis ◽  
Short Form ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Progressive Multiple Sclerosis ◽  
Rehabilitation Outcome ◽  
Motor Disability ◽  
Cerebellar Function ◽  
Vocabulary Skills ◽  
Starting Point

Problem: The diversity of physical and cognitive impairments seen in progressive multiple sclerosis (MS), make it difficult to identify the factors that influence neurorehabilitation outcome. Improvements in a motor disability scale must be considered in the context of the patient's physical and cognitive starting points, if the process of neurorehabilitation is to be properly understood. Method: Data was collected from 38 patients (mean age 41 years, 16 men and 22 women) with clinically definite MS (of whom all but one were in the progressive phase of the disease), who were consecutively admitted to a neurorehabilitation unit. Patients' physical disability was assessed on the motor scale of the Functional Independence Measure (FIM) on admission and discharge. Cognitive and neurological assessments were completed on admission. The cognitive battery comprised the WAIS-R, NART, RMT, CVLT CMT, GNT, GDA, and VOSP (some in short form). Emotional measures were the STAI, STAXI and BDI. Results: The mean improvement on the FIM was 6 points. A multiple regression analysis was performed to determine which cognitive and neurological variables related to reduced disability after neurorehabilitation. To take account of each patient's starting point, the model included their FIM admission score. This variable, together with vocabulary skills and cerebellar function accounted for 57% of the variance in the patients' improvements. These results suggest that verbal intelligence and cerebellar function are influential in determining rehabilitation outcome. Although these findings will be unsurprising to clinicians, this is the first quantitative demonstration of these effects.

scholarly journals Impact of Polypharmacy on the Rehabilitation Outcome of Japanese Stroke Patients in the Convalescent Rehabilitation Ward

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Eiji Kose ◽  
Riku Maruyama ◽  
Susumu Okazoe ◽  
Hiroyuki Hayashi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Laboratory Data ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Drug Reactions ◽  
Stroke Patients ◽  
Rehabilitation Outcome

Background. A risk factor associated with stroke onset is chronic kidney disease (CKD). To prevent stroke reoccurrence, it is necessary to strictly manage blood pressure, lipids, and plasma glucose. Therefore, some cases are forced to polypharmacy, elderly patients in particular. Polypharmacy often leads to adverse drug reactions and has the potential to negatively affect the rehabilitation of stroke patients. The aim of the present study was to investigate the effects of polypharmacy using a functional independence measure (FIM).Methods. A total of 144 stroke patients with CKD were included in the present analysis. We divided stroke patients into those taking six or more drugs (polypharmacy group) and those taking less than six drugs (nonpolypharmacy group) upon admission. Patient background features, laboratory data, and FIM scores were compared.Results. FIM-Motor (FIM-M) efficiency, age, and diabetes mellitus were positively associated with polypharmacy. FIM-M efficiency in the polypharmacy group was significantly lower than in the nonpolypharmacy group.Conclusion. Polypharmacy interferes with the effect of rehabilitation in stroke patients with CKD. Pharmacists and doctors should make efforts to optimize medications to be able to respond to the outcome of each patient.

scholarly journals Post-traumatic seizures and antiepileptic therapy as predictors of the functional outcome in patients with traumatic brain injury

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Valeria Pingue ◽  
Chiara Mele ◽  
Antonio Nardone
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Negative Impact ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Prophylactic Therapy ◽  
Rehabilitation Outcome ◽  
Increased Risk ◽  
Post Traumatic ◽  
Gcs Score

AbstractPost-traumatic seizures (PTS) are a common and debilitating complication of traumatic brain injury (TBI) and could have a harmful impact on the progress of patient rehabilitation. To assess the effect of PTS and relative therapy on outcome in the initial phase after TBI, during the rehabilitation process when neuroplasticity is at its highest, we retrospectively examined the clinical data of 341 adult patients undergoing rehabilitation for at least 6 months post-TBI in our neurorehabilitation unit between 2008 and 2019. We correlated through logistic regression the occurrence of seizures and use of anti-seizure medication (ASM) with neurological and functional outcomes, respectively assessed with the Glasgow Coma Scale (GCS) and the Functional Independence Measure (FIM). PTS were documented in 19.4% of patients: early PTS (EPTS) in 7.0%; late PTS (LPTS) in 9.4%; both types in 3.0%. Patients who developed EPTS had an increased risk of developing LPTS (OR = 3.90, CI 95% 1.58–9.63, p = 0.003). Patients with LPTS had a significantly higher risk of worse neurological (p < 0.0001) and rehabilitation (p < 0.05) outcome. Overall, 38.7% of patients underwent therapy with ASM; prophylactic therapy was prescribed in 24.0% of patients, of whom 14.6% subsequently developed seizures. Mortality was associated with a lower FIM and GCS score on admission but not significantly with PTS. The use of ASM was associated with a worse rehabilitation outcome, independently of the onset of epilepsy during treatment. LPTS appear to exert a negative impact on rehabilitation outcome and their occurrence is not reduced by prophylactic therapy, whereas EPTS do not influence outcome. Our findings caution against the generic use of prophylactic therapy to prevent post-traumatic epilepsy in patients with TBI.

scholarly journals Gait speed as an indicator of prosthetic walking potential following lower limb amputation

2018 ◽  
Vol 43 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Heather R Batten ◽  
Steven M McPhail ◽  
Allison M Mandrusiak ◽  
Paulose N Varghese ◽  
Suzanne S Kuys
Keyword(s):  
Lower Limb ◽  
Gait Speed ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Transtibial Amputation ◽  
And Function ◽  
The Relationship

Background: The relationship between gait speed and prosthetic potential (K-level classifications) and function has not been explored among people transitioning from hospital rehabilitation to the community. Objectives: To examine gait speed at discharge from inpatient rehabilitation among people prescribed a prosthetic leg after unilateral lower limb amputation, and associations between gait speed, prosthetic potential and functional ability. Study design: Cohort. Methods: Gait speed (10-m walk test), K-level (Amputee Mobility Predictor) and Functional Independence Measure motor were compared for 110 people (mean (standard deviation) age: 63 (13) years, 77% male, 71% transtibial amputation, 70% dysvascular causes). Results: Median (interquartile range) gait speed and Functional Independence Measure motor were 0.52 (0.37–0.67) m/s and 84 (81, 85), respectively. Median (IQR) gait speed scores for each K-level were as follows: K1 = 0.17 (0.15–0.19) m/s, K2 = 0.38 (0.25–0.54) m/s, K3 = 0.63 (0.50–0.71) m/s and K4 = 1.06 (0.95–1.18) m/s. Median (IQR) FIM-Motor scores for each K-level were as follows: K1 = 82 (69–84), K2 = 83 (79–84), K3 = 85 (83–87) and K4 = 87 (86–89). Faster gait speed was associated with higher K-level, higher FIM-Motor, being younger, male and having transtibial amputation with nonvascular aetiology. Conclusion: Gait speed was faster among each higher K-level classification. However, gait speeds observed across all K-levels were slower than healthy populations, consistent with values indicating high risk of morbidity and mortality. Clinical relevance Factors associated with faster gait speed are useful for clinical teams considering walking potential of people with lower limb prostheses and those seeking to refine prosthetic rehabilitation programmes.

scholarly journals Clinical rehabilitation of the amputee: A retrospective study

1996 ◽  
Vol 20 (2) ◽  
pp. 72-78 ◽  
Author(s):  
G. M. Rommers ◽  
L. D. W. Vos ◽  
J. W. Groothoff ◽  
W. H. Eisma
Keyword(s):  
Wound Healing ◽  
Lower Limb ◽  
Oncology Group ◽  
Medical Record Data ◽  
Rehabilitation Outcome ◽  
Admission Time ◽  
Prosthetic Fitting ◽  
Record Data ◽  
Wound Healing Problems ◽  
Lower Limb Amputee

The aim of this study was to determine the rehabilitation outcome of lower limb amputee patients after clinical rehabilitation. Altogether 183 amputee patients admitted for clinical rehabilitation in the years 1987–1991 were reviewed by retrospective analysis of medical record data. Three groups of amputee patients were identified by reason for amputation. The vascular group: (N = 132), mean age 67 years, mean admission time 119 days, 85% prosthetic fitting. The oncology group (N = 15), mean age 55 years, mean admission time 77 days, 60% prosthetic fitting. The traumatic amputee group: (N = 14), mean age 41 years, mean stay 134 days and 100% prosthetic fitting. Some 22 patients were bilateral amputees and were assessed separately. The most important reasons for not fitting a prosthesis were oncological metastases, stump and wound healing problems. After rehabilitation 86% of all patients could be discharged home. These results are more favourable than those seen in previous studies.

scholarly journals Reamputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

2020 ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Physical Therapy ◽  
Retrospective Cohort Study ◽  
Lower Limb ◽  
Retrospective Cohort ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Amputation Rate ◽  
Modifiable Risk Factors

Abstract Background：Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods：This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: In diabetes patients with minor amputations, requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and off-loading walking are necessary to reduce the risk of reamputation. Patients with these risk factors should be encouraged to participate in physical therapy.

The Association Between Antipsychotic Drug Use and Rehabilitation Outcome in Post-Acute Hip Fractured Patients: A Retrospective Cohort Study

2020 ◽  
pp. 073346482090456
Author(s):  
Avital Hershkovitz ◽  
Ran Nissan
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence Measure ◽  
Multiple Linear Regression Model ◽  
Functional Independence ◽  
Functional Improvement ◽  
Rehabilitation Outcome ◽  
Rehabilitation Outcomes ◽  
Functional Gain

Antipsychotic (AP) use may lead to numerous side effects which may affect rehabilitation outcomes. A retrospective cohort study was carried out on 448 hip fractured patients admitted to a post-acute geriatric rehabilitation center. Functional improvement was measured by the Functional Independence Measure (FIM), motor FIM (mFIM), and mFIM effectiveness. A multiple linear regression model and regression analysis was used to evaluate the level of association between AP use and achievement of favorable functional gain. AP users exhibited lower functional ability on admission and at discharge, achieved a significantly lower functional gain and required longer rehabilitation time compared with nonusers. AP use by post-acute hip fractured patients negatively affects their chances of achieving favorable rehabilitation outcome after adjustment for confounders.

Sign in / Sign up

Export Citation Format

Share Document