Goal attainment in mobility after acute rehabilitation of mobility-restricting paralysis syndromes with regard to the ambulatory therapeutic level of participation NeuroMoves

Abstract Background A central goal of rehabilitation in patients with paralysis syndromes after stroke or spinal cord injury (SCI) is to restore independent mobility as a pedestrian or wheelchair user. However, after acute rehabilitation, the mobility frequently deteriorates in the ambulatory setting, despite the delivery of rehabilitative interventions such as physical therapy or the prescription of assistive devices. The aim of the NeuroMoves study is to identify factors that are associated with changes of mobility in the ambulatory setting after acute inpatient rehabilitation, with a particular focus on participation according to the ICF (International Classification of Functioning, Disability and Health). Methods The NeuroMoves study is intended as a national multicenter observational cohort study with 9 clinical sites in Germany. A total of 500 patients with mobility-restricting paralysis syndromes (i.e. stroke or SCI) are to be recruited during acute inpatient rehabilitation prior to discharge to the ambulatory setting. Patients will have 8 months of follow-up in the ambulatory setting. Three study visits at the clinical sites (baseline, midterm, and final) are planned at 4-months intervals. The baseline visit is scheduled at the end of the acute inpatient rehabilitation. During the visits, demographical data, neurological, functional, quality of life, and implementation measures will be assessed. At baseline, each study participant receives an activity tracker (sensor for recording ambulatory mobility) along with a tablet computer for home use over the 8 months study duration. While mounted, the activity tracker records mobility data from which the daily distance covered by walking or wheelchair use can be calculated. Customized applications on the tablet computer remind the study participants to answer structured questionnaires about their health condition and treatment goals for physical therapy. Using the study participants’ tablet, therapists will be asked to answer structured questionnaires concerning treatment goals and therapeutic measures they have applied. The primary analysis concerns the association between mobility (daily distance covered) and the degree of participation-oriented rehab interventions. Further exploratory analyses are planned. Discussion The findings could inform healthcare decision-making regarding ambulatory care in Germany focusing on mobility-promoting interventions for patients with mobility-restricting paralysis syndromes. Study registration German Clinical Trials Register, DRKS-ID: DRKS00020487 (18.02.2020).

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Relationship of physical therapy inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab project

Journal of Spinal Cord Medicine ◽

10.1179/2045772312y.0000000058 ◽

2012 ◽

Vol 35 (6) ◽

pp. 503-526 ◽

Cited By ~ 43

Author(s):

Laura Teeter ◽

Julie Gassaway ◽

Sally Taylor ◽

Jacqueline LaBarbera ◽

Shari McDowell ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Physical Therapy ◽

Inpatient Rehabilitation ◽

Patient Characteristics ◽

Cord Injury ◽

Relationship Of

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Group Physical Therapy During Inpatient Rehabilitation for Acute Spinal Cord Injury: Findings From the SCIRehab Study

Physical Therapy ◽

10.2522/ptj.20100392 ◽

2011 ◽

Vol 91 (12) ◽

pp. 1877-1891 ◽

Cited By ~ 11

Author(s):

Jeanne M. Zanca ◽

Audrey Natale ◽

Jacqueline LaBarbera ◽

Sally Taylor Schroeder ◽

Julie Gassaway ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Physical Therapy ◽

Inpatient Rehabilitation ◽

Acute Spinal Cord Injury ◽

Cord Injury

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The EnergyKids Pilot Study: Comparing Energy Balance of Primary School Children during School and Summer Camp

Nutrients ◽

10.3390/nu13010092 ◽

2020 ◽

Vol 13 (1) ◽

pp. 92

Author(s):

Cinzia Franchini ◽

Alice Rosi ◽

Cristian Ricci ◽

Francesca Scazzina

Keyword(s):

Physical Activity ◽

Energy Balance ◽

Weight Status ◽

Summer Camp ◽

Negative Energy ◽

Primary School Children ◽

Food Diary ◽

Activity Tracker ◽

School Time ◽

Study Participants

Children’s energy requirements may vary during school and summer camp days. To evaluate energy balance during these two periods, seventy-eight children (45% females, 8–10 years) living in Parma, Italy, were enrolled in this observational study. Participants completed a 3-day food diary and wore an activity tracker for three consecutive days during a school- and a summer camp-week to estimate energy intake (EI) and energy expenditure (TEE). Height and body weight were measured at the beginning of each period to define children’s weight status. BMI and EI (school: 1692 ± 265 kcal/day; summer camp: 1738 ± 262 kcal/day) were similar during both periods. Both physical activity and TEE (summer camp: 1948 ± 312; school: 1704 ± 263 kcal/day) were higher during summer camp compared to school time. Therefore, energy balance was more negative during summer camp (−209 ± 366 kcal/day) compared to school time (−12 ± 331 kcal/day). Similar results were observed when males and females were analyzed separately but, comparing the sexes, males had a higher TEE and a more negative energy balance than females, during both periods. The results strongly suggest that an accurate evaluation of children’s energy balance, that considers both diet and physical activity, is needed when planning adequate diets for different situations.

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Intensity of usual care physical therapy during inpatient rehabilitation for people with neurologic diagnoses

PM&R ◽

10.1002/pmrj.12577 ◽

2021 ◽

Author(s):

Jake DiPasquale ◽

Molly Trammell ◽

Kelly Clark ◽

Hayden Fowler ◽

Librada Callender ◽

...

Keyword(s):

Physical Therapy ◽

Usual Care ◽

Inpatient Rehabilitation

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Evaluating the Quality of Acute Rehabilitation Care for Patients With Spinal Cord Injury

Quality Management in Health Care ◽

10.1097/qmh.0b013e3181ccbc2a ◽

2010 ◽

Vol 19 (1) ◽

pp. 47-61 ◽

Cited By ~ 11

Author(s):

Haiyan Qu ◽

Richard M. Shewchuk ◽

Yu-ying Chen ◽

J. Scott Richards

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Rehabilitation Care ◽

Cord Injury ◽

Acute Rehabilitation

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Impact of Nosocomial Infection on Length of Stay and Functional Improvement Among Patients Admitted to an Acute Rehabilitation Unit

Infection Control and Hospital Epidemiology ◽

10.1086/501868 ◽

2001 ◽

Vol 22 (02) ◽

pp. 83-87 ◽

Cited By ~ 37

Author(s):

Joseph M. Mylotte ◽

Robin Graham ◽

Lucinda Kahler ◽

B. Lauren Young ◽

Susan Goodnough

Keyword(s):

Length Of Stay ◽

Nosocomial Infection ◽

Functional Status ◽

Functional Independence ◽

Functional Improvement ◽

Multivariate Linear Regression Analysis ◽

Rehabilitation Unit ◽

Cord Injury ◽

Acute Rehabilitation ◽

First Time

AbstractObjective:To identify factors predictive of length of stay (LOS) and the level of functional improvement achieved among patients admitted to an acute rehabilitation unit for the first time, with special reference to the role of nosocomial infection.Setting:A 40-bed acute rehabilitation unit within a 300-bed, tertiary-care, public, university-affiliated hospital.Study Population:All patients admitted to the unit between January 1997 and July 1998.Design:Prospective cohort study in which demographic and clinical data, including occurrence of nosocomial infection, were collected during the entire unit admission of each patient. Multivariate linear regression analysis was used to identify factors predictive of unit LOS or improvement in functional status as measured by the change in the Functional Independence Measure (FIM) score between admission and discharge (ΔFIM).Results:There were 423 admissions to the rehabilitation unit during the study period, of which 91 (21.5%) had spinal cord injury (SCI) as a principal diagnosis. One hundred seven nosocomial infections occurred during 84 (19.9%) of the 423 admissions. The most common infections were urinary tract (31.8% of all infections), surgical-site (18.5%), andClostridium difficilediarrhea (15%). Only one patient died of infection. After controlling for severity of illness on admission, functional status on admission, age, and other clinical factors, the significant positive predictors of unit LOS were as follows: SCI (P<.001), pressure ulcer (.002), and nosocomial infection (<.001). Significant negative predictors of ΔFIM were age (P<.001), FIM score on admission (<.001), prior hospital LOS (.002), and nosocomial infection (.007).Conclusions:Several variables were identified as contributing to a longer LOS or to a smaller improvement in functional status among patients admitted for the first time to an acute rehabilitation unit Of these variables, only nosocomial infection has the potential for modification. Studies of new approaches to prevent infections among patients undergoing acute rehabilitation should be pursued.

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Spinal Cord Tissue Bridges Validation Study: Predictive Relationships With Sensory Scores Following Cervical Spinal Cord Injury

Topics in Spinal Cord Injury Rehabilitation ◽

10.46292/sci21-00018 ◽

2021 ◽

Author(s):

Andrew C. Smith ◽

Denise R. O’Dell ◽

Wesley A. Thornton ◽

David Dungan ◽

Eli Robinson ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

External Validation ◽

Inpatient Rehabilitation ◽

Spinal Cord Tissue ◽

Light Touch ◽

Post Injury ◽

Data Set ◽

Cord Injury ◽

Predictive Relationships

Background: Using magnetic resonance imaging (MRI), widths of ventral tissue bridges demonstrated significant predictive relationships with future pinprick sensory scores, and widths of dorsal tissue bridges demonstrated significant predictive relationships with future light touch sensory scores, following spinal cord injury (SCI). These studies involved smaller participant numbers, and external validation of their findings is warranted. Objectives: The purpose of this study was to validate these previous findings using a larger independent data set. Methods: Widths of ventral and dorsal tissue bridges were quantified using MRI in persons post cervical level SCI (average 3.7 weeks post injury), and pinprick and light touch sensory scores were acquired at discharge from inpatient rehabilitation (average 14.3 weeks post injury). Pearson product-moments were calculated and linear regression models were created from these data. Results: Wider ventral tissue bridges were significantly correlated with pinprick scores (r = 0.31, p < 0.001, N = 136) and wider dorsal tissue bridges were significantly correlated with light touch scores (r = 0.31, p < 0.001, N = 136) at discharge from inpatient rehabilitation. Conclusion: This retrospective study’s results provide external validation of previous findings, using a larger sample size. Following SCI, ventral tissue bridges hold significant predictive relationships with future pinprick sensory scores and dorsal tissue bridges hold significant predictive relationships with future light touch sensory scores.

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

Stroke ◽

10.1161/str.45.suppl_1.tp243 ◽

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.

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