scholarly journals Potential Predictors of Motor and Functional Outcomes After Distributed Constraint-Induced Therapy for Patients With Stroke

2008 ◽  
Vol 23 (4) ◽  
pp. 336-342 ◽  
Author(s):  
Keh-chung Lin ◽  
Yan-hua Huang ◽  
Yu-wei Hsieh ◽  
Ching-yi Wu
Keyword(s):  
Upper Extremity ◽  
Distal Part ◽  
Functional Performance ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Ability ◽  
Motor Pathways ◽  
Movement Performance ◽  
Quality Of Movement ◽  
Motor Outcomes

Background. Selection of patients who are most and least likely to benefit from constraint-induced therapy (CIT) for the upper extremity is uncertain. Objective. This study investigated demographic and clinical characteristics that may predict outcomes for a distributed form of CIT. Methods. A group of 57 patients were treated with distributed CIT, and 7 potential predictors were identified, including age, sex, side of stroke, time since stroke, spasticity, neurologic status, and movement performance of the distal part of the upper extremity. Treatment outcome was assessed in terms of motor performance, perceived functional ability of the affected hand, and functional performance of daily activities, measured by Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Functional Independence Measure (FIM), respectively. Results. Motor ability of the distal part of the upper extremity and time since stroke were significantly predictive of outcomes on the FMA (adjusted R2 = 0.18, P = .002) and the MAL subtest quality of movement (adjusted R 2 = 0.43, P < .0001). Motor ability and age were significant predictors of amount of use measured by the MAL (adjusted R2 = 0.20, P = .001). None of the variables exhibited a predictive relationship with the FIM. Conclusions. The best predictor for motor outcomes after distributed CIT was greater motor ability of the distal part of the upper extremity, which is consistent with the presence of residual motor pathways that may respond to training. The FMA may be of value in stratifying patients for their likelihood to benefit from distributed CIT protocols.

The Potential Predictors of Motor Performance Outcomes after Rehabilitation for Patients with Stroke

2013 ◽  
Vol 284-287 ◽  
pp. 1656-1660
Author(s):  
Jiann Der Lee ◽  
Tzyh Chyang Chang ◽  
Shih Ting Yang ◽  
Chung Hsien Huang ◽  
Ching Yi Wu
Keyword(s):  
Motor Performance ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Performance Outcomes ◽  
Motor Ability ◽  
Stroke Patients ◽  
Performance Outcome ◽  
Rehabilitation Outcomes ◽  
Movement Performance ◽  
Motor Outcome

The identification of potential predictors for motor outcome after rehabilitation helps underscore the factors that may affect treatment outcomes and target individuals who benefit the most from the therapy. In this study, we addressed and utilized a classifier to identify the potential predictors for motor performance outcome for patients with stroke after rehabilitation. The potential predictors selected and used by different assessments in this study were age, sex, time since stroke, education, neurologic status, and the movement performance of the upper extremity. This study aimed to identify predictors of motor performance outcomes after rehabilitation for stroke patients. The PSO-SVM was chosen in this study to find the predictor of motor function for clients with stroke. The potential predictors for motor outcome after rehabilitation were motor ability assessment of the Fugl-Meyer Assessment (FMA) and the Functional Independence Measure (FIM). This study is to investigate the potential demographic and clinical characteristics of stroke that can serve to predict rehabilitation outcomes in motor performance.

scholarly journals Impact of structured physical therapy intervention on functional recovery in a patient with CAPOS syndrome: a case report

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shailesh Gardas ◽  
Aishwarya Mahajan
Keyword(s):  
Functional Performance ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Measurement Scale ◽  
Manual Muscle Testing ◽  
Trunk Control ◽  
Control Measurement ◽  
Muscle Testing ◽  
Post Test ◽  
Capos Syndrome

Abstract Background CAPOS syndrome (cerebellar ataxia, areflexia, pescavus, optic atrophy, and sensorineural hearing loss) is a rare congenital autosomal dominant disorder. The resulting neurological sequelae of impairments are progressive in nature and may interfere with functional independence, performing activities of daily living (ADL’s), and subsequently, affecting the quality of life (QOL). Since it is an extremely rare disorder, there is a severe dearth in the literature about how specific physiotherapy interventions may affect their functional status. Therefore, our objective was to investigate the effects of proprioceptive neuromuscular facilitation (PNF) and Frenkel’s coordination exercises on functional recovery in a patient with CAPOS syndrome. Case presentation We herein present a case of a 25-year-old Indian male with complaints of generalized body weakness, difficulty visualizing distant objects, nystagmus, progressive sensorineural deafness, and ataxia. He was rehabilitated with a structured/customized physiotherapy protocol consisting of PNF approach and coordination exercises for 4 weeks, 6 days/week, 60 min daily. An improvement in overall functional performance of patient as per post-intervention scores of manual muscle testing, trunk control measurement scale, functional independence measure (components of self-care, transfers, and locomotion), and decline in severity of ataxia on scale for assessment and rating of ataxia scale was observed. Conclusion PNF and Frenkel’s exercises resulted in an improvement in overall functional performance of the patient. Improvement was observed in post-test scores of Manual Muscle Testing (MMT), Trunk Control Measurement Scale (TCMS), and Functional Independence Measure (FIM) for the components of self-care, transfers, and locomotion. Additionally, results also showed a decline in severity of ataxia on post-test scores of scale for the assessment and rating of ataxia (SARA) scale (i.e., from severe to moderate).

scholarly journals Interdisciplinary Therapy for patients with dementia

2014 ◽  
Vol 8 (3) ◽  
pp. 285-290
Author(s):  
Maysa Luchesi Cera ◽  
Daniela Cristina Carvalho de Abreu ◽  
Rosângela de Abreu Venancio Tamanini ◽  
Amanda Carla Arnaut ◽  
Patrícia Pupin Mandrá ◽  
...  
Keyword(s):  
Intervention Program ◽  
Functional Performance ◽  
Functional Dependence ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Clinical Dementia Rating ◽  
Interdisciplinary Intervention

Patients with dementia require rehabilitation involving several health professionals, where interdisciplinary care can further enhance the routine of patients and their families.OBJECTIVE:To compare the functional performance of elderly with dementia before and after an interdisciplinary intervention program provided by a healthcare service of medium complexity.METHODS: Three cases with clinically-confirmed dementia enrolled on an interdisciplinary rehabilitation program were reported. The following instruments were applied: Mini Mental-State Exam, Clinical Dementia Rating, Geriatric Depression Scale, Lawton & Brody Index, and the Functional Independence Measure for adults (FIM). The therapeutic strategies were individualized and designed based on patient performance on the FIM, according to the criteria of the Classification of Functionality, Disability and Health, implemented at the house of therapy of the Center for Integrated Rehabilitation together with provision of guidance.RESULTS: A reduction in functional dependence was observed after intervention, evidenced by less supervision needed to carry out Activities of Daily Living. Conclusion: The three patients benefited from the interdisciplinary intervention.

scholarly journals Combined Effects of Telehealth and Modified Constraint-Induced Movement Therapy for Individuals with Chronic Hemiparesis

2020 ◽  
Vol 12 (1) ◽  
pp. 51-62
Author(s):  
Mary Ann Smith ◽  
Machiko R. Tomita
Keyword(s):  
Upper Extremity ◽  
Functional Ability ◽  
Functional Independence Measure ◽  
Cost Savings ◽  
Movement Therapy ◽  
Functional Independence ◽  
Potential Cost ◽  
Wolf Motor Function Test ◽  
Group 2 ◽  
Group 1

Telehealth use allows improved access to services and results in potential cost savings. The purpose of this study was to examine the effectiveness of a combined modified Constrained Induced Movement Therapy (mCIMT) program using telehealth and in-person sessions, for participants with higher (Group 1) and lower (Group 2) functional ability of the hemiparetic upper extremity. Using a pre-experimental design with a 6-week intervention, 28 participants were assessed twice on use of upper extremity via subjective and objective measures. For the Motor Activity Log, the amount of use and quality of use were significant for Groups 1 and 2.  Significant improvements were shown on the Wolf Motor Function Test (WMFT), the Fugl-Meyer UE, and the Functional Independence Measure (FIM) for both groups except for the strength subtest on the WMFT and the timed portion for Group 1. Percentages of attendance for telehealth and in-person sessions were also compared. Telehealth sessions had a higher attendance rate (84.5%) than in-person sessions (75.3%) (p=.004). The combined mCIMT program of telerehabilitation and in-person group sessions was effective in improving functional ability after a stroke.    

scholarly journals FUNCTIONALITY OF UPPER GASTROINTESTINAL CANCER PATIENTS WHICH HAVE UNDERTAKEN SURGERY IN HOSPITAL PHASE

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Epamela Sulamita Vitor de CARVALHO ◽  
Ana Cristina Machado LEÃO ◽  
Anke BERGMANN
Keyword(s):  
Gastrointestinal Tract ◽  
Cancer Patients ◽  
Gastrointestinal Cancer ◽  
Functional Performance ◽  
Handgrip Strength ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Preoperative Period ◽  
Upper Gastrointestinal Cancer ◽  
Upper Gastrointestinal

ABSTRACT Background: Cancer patients present various physiological, metabolic, social and emotional changes as a consequence of the disease’s own catabolism, and may be potentiated in the gastrointestinal tract cancer by their interference with food intake, digestion and absorption. Aim: T o evaluate the functionality of upper gastrointestinal cancer patients which have undertaken surgery and analyze the factors associated with changes in strength and functionality during hospitalization time. Methods: Prospective analytical study in patients with cancer of the upper gastrointestinal tract which have undertaken surgery. Was evaluated the handgrip strength using a hand dynamometer and functionality through the functional independence measure and Functional Status Scale for Intensive Care Unit in the preoperative period, 2nd and 7th postoperative day. Results: Were included 12 patients, 75% men, and mean age was 58.17 years old. The most prevalent tumor site was stomach (66.7%). There was a progressive reduction from the pre-operative palmar grip strength to the 2nd and 7th postoperative day, respectively. There was a decrease in functional performance from the preoperative period to the 2nd and a gain from the 2nd to the 7th postoperative day (p<0.001). Conclusion: An important reduction in the handgrip strength and functionality was evidenced during the postoperative period in relation to the basal value in the pre-operative period.

scholarly journals Reinforced Feedback in Virtual Environment for Rehabilitation of Upper Extremity Dysfunction after Stroke: Preliminary Data from a Randomized Controlled Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Paweł Kiper ◽  
Michela Agostini ◽  
Carlos Luque-Moreno ◽  
Paolo Tonin ◽  
Andrea Turolla
Keyword(s):  
Randomized Controlled Trial ◽  
Virtual Environment ◽  
Upper Extremity ◽  
Motor Function ◽  
Upper Limb ◽  
Controlled Trial ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Stroke Etiology ◽  
Randomized Controlled

Objectives. To study whether the reinforced feedback in virtual environment (RFVE) is more effective than traditional rehabilitation (TR) for the treatment of upper limb motor function after stroke, regardless of stroke etiology (i.e., ischemic, hemorrhagic).Design. Randomized controlled trial.Participants. Forty-four patients affected by stroke.Intervention. The patients were randomized into two groups: RFVE (N=23) and TR (N=21), and stratified according to stroke etiology. The RFVE treatment consisted of multidirectional exercises providing augmented feedback provided by virtual reality, while in the TR treatment the same exercises were provided without augmented feedbacks.Outcome Measures. Fugl-Meyer upper extremity scale (F-M UE), Functional Independence Measure scale (FIM), and kinematics parameters (speed, time, and peak).Results. The F-M UE (P=0.030), FIM (P=0.021), time (P=0.008), and peak (P=0.018), were significantly higher in the RFVE group after treatment, but not speed (P=0.140). The patients affected by hemorrhagic stroke significantly improved FIM (P=0.031), time (P=0.011), and peak (P=0.020) after treatment, whereas the patients affected by ischemic stroke improved significantly only speed (P=0.005) when treated by RFVE.Conclusion. These results indicated that some poststroke patients may benefit from RFVE program for the recovery of upper limb motor function. This trial is registered withNCT01955291.

scholarly journals Predictive Value of Circulating Insulin-Like Growth Factor I Levels in Ischemic Stroke Outcome

2006 ◽  
Vol 91 (10) ◽  
pp. 3928-3934 ◽  
Author(s):  
Marta Bondanelli ◽  
Maria Rosaria Ambrosio ◽  
Alessandro Onofri ◽  
Antonella Bergonzoni ◽  
Susanna Lavezzi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Performance ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Stroke Outcome ◽  
Pituitary Dysfunction ◽  
Igf I ◽  
The Difference ◽  
Age Range

Abstract Context: Cerebrovascular disease is highly prevalent in the general population, frequently leading to permanent invalidity and reduced quality of life. IGF-I is recognized as an important neuroprotective factor against cerebral hypoxic insult. Objective: The objective of the study was to evaluate pituitary function, in particular GH-IGF-I axis, in adult patients receiving rehabilitation after an ischemic stroke. Subjects and Methods: We studied 42 patients (12 females; age range, 50–88 yr) during rehabilitation after stroke, evaluating the relationship between the GH-IGF-I axis and the severity (National Institutes of Health stroke scale) and outcome [Rancho Los Amigos Scale of Cognitive Functioning (LCFS); Functional Independence Measure (FIM); modified Ranking Scale] from stroke. Results: GH deficiency was demonstrated in five patients (11.9%). Peak GH after GHRH + arginine test and IGF-I levels did not correlate with severity of stroke. IGF-I was positively correlated with LCFS (r = 0.305, P &lt; 0.05) and the difference between FIM on admission and at discharge from rehabilitation (ΔFIM; r = 0.361, P &lt; 0.02). Outcome indexes (LCFS, FIM at discharge, ΔFIM) and occurrence of favorable outcome (modified Ranking Scale 0–1) were significantly (P &lt; 0.05) higher in patients with IGF-I levels 161.8 μg/dl or greater (50th percentile of the patient distribution). LH-FSH deficiency (three cases), ACTH deficiency (one case), and hyperprolactinemia (two cases) were detected. One patient had primary hypogonadism, and six males had low testosterone with normal LH and FSH levels. By multivariate analysis, IGF-I level was the main significant predictor of ΔFIM and LCFS. Conclusions: Ischemic stroke may be associated with pituitary dysfunction, particularly GH and gonadotropin deficiencies. The higher IGF-I levels observed in patients with better outcome suggest a possible neuroprotective role of IGF-I. Circulating IGF-I may predict functional performance during rehabilitation and ischemic stroke outcome.

scholarly journals Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery

2020 ◽  
Author(s):  
Melanie K Fleming ◽  
Tom Smejka ◽  
David Henderson Slater ◽  
Veerle van Gils ◽  
Emma Garratt ◽  
...  
Keyword(s):  
Brain Injury ◽  
Sleep Quality ◽  
Functional Recovery ◽  
Motor Impairment ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rate Of Change ◽  
Sleep Fragmentation ◽  
Motor Outcomes

AbstractBackground and AimsSleep is important for consolidation of motor learning, but brain injury may affect sleep continuity and therefore rehabilitation outcomes. This study aims to assess the relationship between sleep quality and motor recovery in brain injury patients receiving inpatient rehabilitation.Methods59 patients with brain injury were recruited from two specialist inpatient rehabilitation units. Sleep quality was assessed (up to 3 times) objectively using actigraphy (7 nights) and subjectively using the Sleep Condition Indicator. Motor outcome assessments included: Action Research Arm test (upper limb function), Fugl Meyer assessment (motor impairment) and the Rivermead Mobility Index. The functional independence measure (FIM) was assessed at admission and discharge by the clinical team. 55 age and gender matched healthy controls completed one assessment.ResultsInpatients demonstrated lower self-reported sleep quality (p<0.001) and more fragmented sleep (p<0.001) than controls. For inpatients, sleep fragmentation explained significant additional variance in motor outcomes, over and above that explained by admission FIM score (p<0.017), such that more disrupted sleep was associated with poorer motor outcomes. Using stepwise linear regression, sleep fragmentation was the only variable found to explain variance in rate of change in FIM (R2adj = 0.12, p = 0.03), whereby more disrupted sleep was associated with slower recovery.ConclusionsInpatients with brain injury demonstrate impaired sleep quality, and this is associated with poorer motor outcomes and slower functional recovery. Further investigation is needed to determine how sleep quality can be improved and whether this affects outcome.

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