Abstract WP195: Patients Beginning Community Based Outpatient Stroke Rehabilitation Program More Than 6 Months Post Stroke Achieve Equally Excellent Outcomes as Sub-Acute Patients

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Joan Breen ◽  
Jeanne Andrusin ◽  
Tom Ferlito
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Rehabilitation Program ◽  
Chronic Stroke ◽  
Outpatient Rehabilitation ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Community Based ◽  
Post Stroke ◽  
Rehabilitation Programs

Background: Despite the availability of community based outpatient rehabilitation programs in the U.S., few use standardized measure sets and assessments, and outcomes studies are sparse. There is especially a knowledge gap regarding outcomes of participating chronic stroke patients (rehabilitation begins more than 6 months post stroke). Methods: Prospective observational study of stroke patients treated between 12/2011-1/2015 in an interdisciplinary outpatient rehabilitation program that addresses health literacy, risk factors, physical, psychosocial, cognitive, communicative and vocational issues. Patients were classified as chronic if admitted to the program >6 months and sub-acute if admitted <6 months post stroke. Results: Among 96 consecutive patients, 71 were sub-acute (72% ischemic, 28% hemorrhages) and 25 chronic (68% ischemic, 32% hemorrhages) who were admitted to the program an average 18.5 months post stroke (range 6-121 months). Chronic vs subacute stroke patients were 64% vs 59% male, with no difference in age (mean 66, range 27-90 years vs 65, range 18-90 years), but with greater stroke severity (chronic mean NIHSS score 8.32, range 2-15 vs subacute NIHSS of 5.2, range 0-16). On admission, chronic vs subacute patients were 44% vs 34% aphasic and 96% vs 86% needed assistance with activities of daily living (chronic with modified Rankin Scale [mRS] of 3=28% and 4=68% vs subacute mRS of 3=65% and 4=21%). The percent change in outcomes from baseline to program discharge for subacute and chronic stroke patients is presented in the Table. Conclusions: Although age, sex and stroke types were similar in both groups, chronic patients were more severely impaired than subacute patients but achieved greater improvement in activities of daily living, recovery, walking speed, balance, and risk factor knowledge. These findings demonstrate that outpatient rehabilitation programs can aid in stroke recovery independent of time since stroke onset.

scholarly journals Factors Affecting the Activities of Daily Living of Chronic Stroke Patients Requiring Long-term Care

2016 ◽  
Vol 31 (2) ◽  
pp. 325-328
Author(s):  
Tomohiko KAMO ◽  
Katsuhiko EGUCHI ◽  
Hideaki ISHII ◽  
Yusuke NISHIDA
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Long Term Care ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Term Care ◽  
Factors Affecting

scholarly journals The Comparison Of Relationship Of Depression,Cognitive,Motor And Functional Deficities In Chronic Stroke Patients (A Pilot Study)

2017 ◽  
pp. 28
Author(s):  
Amin Ghaffari ◽  
Malahat Akbarfahimi ◽  
Bijan Forough
Keyword(s):  
Pilot Study ◽  
Activities Of Daily Living ◽  
Verbal Memory ◽  
Daily Living ◽  
Cognitive Rehabilitation ◽  
Cross Sectional Study ◽  
Chronic Stroke ◽  
Cross Sectional ◽  
Post Stroke ◽  
Post Stroke Depression

Aim and background: One of the most important psychological disorders that arise after a stroke for people with subsequent depression, which leads to reduced quality of life, optimal rehabilitation failure, loss of cognitive tasks and decrease the recovery process.In this study communication patterns of depression with cognitive, motor and function deficites in people with chronic stroke has been studied.Methods and materials: it is a pilot study of cross-sectional study, 40 patients with chronic stroke (more than 6 months) selected sampling method. depression (Beck Depression Inventory), cognition (attention test TMT-A & B and Wechsler memory), motor (Motorcity index), basic activities of daily living (Barthel scale) and instrumental activities of daily living (Lawton scale) were evaluated.Results: The results of the study revealed a significant positive correlation between post stroke depression with verbal memory(r=./386 ،P<./05), attention(r=./549 ،P<./05), motor status(r=./550 ،P<./05) and independence in activities of daily living(r=./653 ،P<./05)Conclusion: According to the findings, the study of factors affecting  post stroke depression(PSD) clinical and practical aspects are necessary. Cognitive rehabilitation programs with motor rehabilitation can reduce depression in patients with stroke in the direction of independence in activities of daily living and greater participation in society .    

scholarly journals A Comparison of the Relation of Depression, and Cognitive, Motor and Functional Deficits in Chronic Stroke Patients: A Pilot Study

2017 ◽  
Vol 5 (4) ◽  
pp. 1
Author(s):  
Amin Ghaffari ◽  
Malahat Akbarfahimi ◽  
Bijan Forough
Keyword(s):  
Activities Of Daily Living ◽  
Verbal Memory ◽  
Daily Living ◽  
Cognitive Rehabilitation ◽  
Recovery Process ◽  
Chronic Stroke ◽  
Cross Sectional ◽  
Post Stroke ◽  
Instrumental Activities ◽  
Post Stroke Depression

Aim and background: One of the most important psychological disorders after stroke is depression, which leads to reduced quality of life, optimal rehabilitation failure, loss of cognitive tasks and decrease in the recovery process. In this research, relation between patterns of depression and cognitive, motor and function deficits in people with chronic stroke was studied. Methods and materials: In a pilot cross-sectional study, 40 patients with chronic stroke (more than 6 months) were enrolled. Depression (Beck Depression Inventory), cognition (attention test TMT-A & B and Wechsler memory), motor (Motorcity index), basic activities of daily living (Barthel scale) and instrumental activities of daily living (Lawton scale) were evaluated. Results: The results of the study revealed a significant positive correlation between post stroke depression and verbal memory (r=0.440،P<.05), attention (r=0.615،P<.05), motor function(r-0.368،P<.05), independence in basic activities of daily living (r=0.781،P<.05) and instrumental activities of daily living (r=0.741, P<.05). Conclusion: According to the findings, further studies of factors affecting post stroke depression (PSD) clinical and practical aspects are necessary. Cognitive rehabilitation programs with motor rehabilitation can decrease depression and gain independence in activities of daily living and more participation in society activities.

scholarly journals Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 255
Author(s):  
Tatsuya Matsushita ◽  
Shinta Nishioka ◽  
Shiori Taguchi ◽  
Anna Yamanouchi ◽  
Ryusei Nakashima ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Functional Independence ◽  
The Body ◽  
Sarcopenic Obesity ◽  
Fat Percentage ◽  
Stroke Patients ◽  
Post Stroke ◽  
Simple Obesity

Reports investigating the relationship between sarcopenic obesity and activities of daily living in older patients with stroke were limited. This study aimed to examine the prevalence of sarcopenic obesity and its association with activities of daily living in older post-stroke patients in convalescent rehabilitation wards. This study was performed in older post-stroke patients admitted to convalescent rehabilitation wards between January 2017 and March 2019. Sarcopenia was diagnosed based on the skeletal muscle mass index and hand grip strength according to the criteria of the 2019 Asian Working Group for Sarcopenia. Obesity was diagnosed according to the body fat percentage; ≥27% in men, ≥38% in women. The primary outcome was the Functional Independence Measure (FIM) score upon admission, which was analyzed using multiple linear regression. In total, 376 participants (women 44%; mean age 77.5 years) were analyzed and classified as normal (22%), simple obesity (17%), sarcopenia without obesity (32%), and sarcopenic obesity (28%). The presence of sarcopenic obesity was independently associated with the FIM score (95% CI, −16.157 to −5.353), whereas simple obesity and sarcopenia without obesity were not. In conclusion, sarcopenic obesity was independently associated with lower activities of daily living capability in older patients with stroke.

Abstract TP210: Examining the Role of Context: Neighborhood Socioeconomic Status Shaping Post-Stroke Outcomes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Eric Stulberg ◽  
Erica Twardzik ◽  
Chia-Wei Hsu ◽  
Sehee Kim ◽  
Philippa Clarke ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Neighborhood Context ◽  
Stroke Recovery ◽  
Future Research ◽  
Stroke Severity ◽  
Stroke Outcomes ◽  
Neighborhood Socioeconomic Status ◽  
Post Stroke

Introduction: Neighborhoods may influence post-stroke recovery. We examined the association between neighborhood socioeconomic status (nSES) and 90-day post-stroke function, depression, cognition, and quality of life (QoL). Methods: Stroke survivors (N=782) were identified from the population-based Brain Attack Surveillance in Corpus Christi (BASIC) Project. An nSES index – composite of 2010 census-tract level income, wealth, education, employment – was the exposure; higher values indicate higher nSES (median -4.56; IQR: -7.48 to -0.46). Function was measured with 22 self-reported activities of daily living/instrumental activities of daily living, depression with Patient Health Questionnaire-8, QoL with the Stroke Specific QoL Scale, and cognition with the Modified Mini Mental State Examination. Confounder-adjusted generalized estimating equations were used to estimate associations between nSES (comparing 75 th to 25 th percentile) and 90-day outcomes. We tested for effect modification by initial stroke severity (NIH Stroke Scale (NIHSS) ≤ 5 or >5) by including interaction terms in adjusted models. Results: Higher nSES was associated with significantly better function, better QoL, and less depression after adjusting for person-level confounders in those with NIHSS >5. Higher nSES was associated with better cognition, but this result was not significant. In those with NIHSS ≤5, higher nSES had a statistically significant (though attenuated) association with function and cognition. Conclusions: Future research should identify features of higher nSES neighborhoods that contribute to more favorable stroke outcomes. Our findings highlight the need for examining the individual and joint influence of neighborhood context and stroke severity on post-stroke recovery.

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