scholarly journals Functional recovery in post-stroke patients on hemodialysis during the convalescent phase: a comparison with those not undergoing hemodialysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takeki Ishida ◽  
Kenichi Kono ◽  
Yuusuke Nishida ◽  
Masahiro Yoshida
Keyword(s):  
Functional Recovery ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Hemodialysis Patients ◽  
Stroke Patients ◽  
Post Stroke ◽  
Rehabilitation Hospital ◽  
Convalescent Phase ◽  
The Difference ◽  
Impaired Motor Function

Abstract Background Low physical fitness is often found in patients undergoing hemodialysis. It may be possible that the recovery of impaired motor function with rehabilitative training might be affected when the patient is on hemodialysis. So far, however, no researcher has clinically investigated this issue in post-stroke patients. The purpose of this study is to clarify the difference of functional recovery during the convalescent phase between post-stroke patients with and without hemodialysis. Methods A cohort of 82 post-stroke hemiparetic patients who were admitted to our rehabilitation hospital, were subjected. On the day of admission and discharge, some clinical parameters including Functional Independence Measure (FIM) and Functional Ambulation Category (FAC) were evaluated for each patient. The changes during the hospitalization and the values at the discharge in these parameters were statistically compared between the patients with and without hemodialysis. Results The FIM motor score at the discharge was significantly lower in hemodialysis patients than non-hemodialysis patients (64.7 ± 21.2 points in hemodialysis patients and 81.8 ± 28.0 points in non-hemodialysis patients, p < 0.05). In addition, the frequency of FAC at the discharge of ≥ 3 was significantly lower in hemodialysis patients than non-hemodialysis patients (40.0% in hemodialysis patients and 72.2% in non-hemodialysis patients, p < 0.05). Conclusion In patients undergoing hemodialysis seem to experience a worse functional recovery during the convalescent phase compared to those not undergoing hemodialysis. We might have to modify the rehabilitative program during the convalescent phase after stroke if the patient was on hemodialysis.

Adipokines as Potential Biomarkers in the Neurorehabilitation of Obese Stroke Patients

2020 ◽  
Vol 17 (4) ◽  
pp. 437-445
Author(s):  
Irene Ciancarelli ◽  
Giovanni Morone ◽  
Marco Iosa ◽  
Stefano Paolucci ◽  
Loris Pignolo ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Functional Recovery ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Enzyme Linked Immunosorbent Assay ◽  
Stroke Patients ◽  
Rehabilitation Outcomes ◽  
Before And After ◽  
Forward Stepwise ◽  
Clinical Measures

Background: Limited studies concern the influence of obesity-induced dysregulation of adipokines in functional recovery after stroke neurorehabilitation. Objective: To investigate the relationship between serum leptin, resistin, and adiponectin and functional recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential significance as prognostic markers of rehabilitation outcomes was also verified. Methods: Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale (mRS), and Functional Independence Measure (FIM). Results: Compared to controls, higher leptin and resistin values and lower adiponectin values were observed in stroke patients before neurorehabilitation and no correlations were found between adipokines and clinical outcome measures. Neurorehabilitation was associated with improved scores of BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and resistin together increased adiponectin were detected in stroke patients, while leptin decreased but not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score, and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified leptin as prognostic factor for BI, mRS, and FIM. Conclusions: Our data show the effectiveness of neurorehabilitation in modulating adipokines levels and suggest that leptin could assume the significance of biomarker of functional recovery.

scholarly journals Postural Assessment Scale for Stroke Patients in Acute, Subacute and Chronic Stage: A Construct Validity Study

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 365
Author(s):  
Cecilia Estrada-Barranco ◽  
Roberto Cano-de-la-Cuerda ◽  
Vanesa Abuín-Porras ◽  
Francisco Molina-Rueda
Keyword(s):  
Construct Validity ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Assessment Scale ◽  
Validity Study ◽  
Stroke Patients ◽  
Chronic Stage ◽  
Post Stroke ◽  
Valid Instrument ◽  
Postural Assessment

(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months).

scholarly journals Does cognition influence the functional impairment degree of post-stroke patients?

2020 ◽  
pp. 1-4
Author(s):  
Ozair Argentille Pereira da Silva ◽  
Gabriele Natane de Medeiros Cirne ◽  
Edson Meneses da Silva Filho ◽  
Enio Walker Azevedo Cacho ◽  
Roberta de Oliveira Cacho
Keyword(s):  
Motor Impairment ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Temporal Orientation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Motor Abilities ◽  
Sociodemographic Data ◽  
Cognitive Levels ◽  
Sensory Motor

Background: The post-stroke subjects have several sequelae after the disease, which should be investigated and identified so that the clinical treatment includes these people in all aspects. Objective: To identify if there is a correlation between level of education, cognitive function, functional independence and the sensory-motor abilities of post-stroke subjects. Methods: The sample consisted of 27 post-stroke patients who were evaluated through the following scales: Mini-Mental State Exam (MMSE), Functional Independence Measure (FIM) and Fugl-Meyer Assessment (FMAA) and sociodemographic data collection. Results: A positive and statistically significant correlation was found between MMSE and FIM. When the scores were correlated with education, motor FIM (p = 0.005), total FIM (p = 0.006), temporal orientation MMSE (p = 0.03) and total MMSE (p = 0.01) were statistically significant. Furthermore, a positive correlation but not statistically significant was identified between the cognitive levels and sensory-motor impairment assessed by FMAA. Conclusion: It is concluded that the education of subjects is associated with motor function after stroke. In addition, cognitive impairments interfere with the level of post-stroke functionality, but do not have a direct influence on the degree of sensory-motor impairment.

Prevalence of Hemiplegic Shoulder Pain in Post-stroke Patients – A Hospital Based Study

2012 ◽  
Vol 23 (1) ◽  
pp. 15-19 ◽  
Author(s):  
AK Joy ◽  
I Ozukum ◽  
L Nilachandra ◽  
Th Khelendro ◽  
Y Nandabir ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Functional Recovery ◽  
Muscle Tone ◽  
Brain Lesion ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Post Stroke ◽  
Severity Of Disability ◽  
Lost To Follow Up

Abstract Objectives To study the prevalence of hemiplegic shoulder pain (HSP) and its association with other factors like age, sex, side of paralysis, type of brain lesion, muscle tone, degree of functional recovery in upper limb and glenohumeral subluxation (GHS). Methodology Prospective study based on all the hemiplegic 140 patients admitted in the physical medicine and rehabilitation ward in two consecutive years. Tools Assessment of HSP was done by using a structured questionnaire known as “Shoulder Q”. Modified Ashworth scale (MAS) was used for spasticity assessment and functional independence measure (FIM) to document the severity of disability. Follow-up at intervals of 1, 3 and 6 months from the date of discharge for all cases were attempted and even cases with at least one follow-up around 3 months were also included in the study. Analysis was done on 109 patients as 31 patients lost to follow-up. Results Out of the 109 patients, 61.5% were males with a mean age of 58.9 ± 10.9 years. Cerebral infarct represents 53.2% of patients. HSP was present in 47.7% (n= 52) of patients. The prevalence of HSP on left and right sides was comparable though involvement was more on the left side (58.8%). Glenohumeral subluxation was present in 32.7% (n=17) of 52 cases with HSP and 33.3% (n=19) of 57 cases without HSP. Mean FIM score at admission for patients with HSP was 54.5 ± 17.6 and 56.6 ± 19.5 among cases without HSP. Again, mean FIM scores at last follow-up were 80.0 ± 16.4 and 79.9 ± 18.9 respectively for both cases with HSP and without it. Among the compliers, patients with tone more than MAS=1 were more likely to develop HSP. Conclusion Prevalence rate of HSP among post-stroke hemiplegic patients admitted during two years was 47.7%. There was no association of HSP with factors like age, sex, side of paralysis, type of lesion and GHS. Correlation between HSP and muscle tone or degree of functional recovery was significant.

scholarly journals Correlation of Body Composition and Nutritional Status with Functional Recovery in Stroke Rehabilitation Patients

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1923 ◽  
Author(s):  
Hiroshi Irisawa ◽  
Takashi Mizushima
Keyword(s):  
Nutritional Status ◽  
Muscle Mass ◽  
Functional Recovery ◽  
Stroke Rehabilitation ◽  
Risk Index ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Nutritional Risk ◽  
Stroke Patients ◽  
Nutritional Risk Index

Previous studies have suggested that the nutritional status after stroke is independently associated with long-term outcomes and that sarcopenia delays poststroke rehabilitation and worsens the prognosis. However, many stroke patients have a deteriorated nutritional status and a decreased muscle mass in the acute phase. This prospective study included 179 patients who were admitted to the stroke rehabilitation unit. We performed bioelectrical impedance analysis and determined the Geriatric Nutritional Risk Index (GNRI) to assess muscle mass and the nutritional status on admission. Furthermore, we analyzed the activities of daily living using the Functional Independence Measure (FIM) at the time of admission and four weeks later. Furthermore, we evaluated the change in motor FIM items and examined the relationship with the data. Multiple regression analysis revealed that a high muscle rate (skeletal muscle mass/body weight) (odds ratio OR = 2.43), high phase angle (OR = 3.32), and high GNRI (OR = 2.57) were significantly associated with motor FIM items at four weeks in male and female patients. Muscle mass maintenance through nutritional management and early rehabilitation in the acute period of stroke is essential for functional recovery in stroke patients.

scholarly journals Does botulinum toxin improve the function of the patient with spasticity after stroke?

2007 ◽  
Vol 65 (3a) ◽  
pp. 592-595 ◽  
Author(s):  
Eduardo Cardoso ◽  
Glícia Pedreira ◽  
Antônio Prazeres ◽  
Nildo Ribeiro ◽  
Ailton Melo
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Functional Independence Measure ◽  
Botulinum Toxin Type ◽  
Functional Independence ◽  
Functional Improvement ◽  
Stroke Patients ◽  
Early Management ◽  
Post Stroke ◽  
Upper Limb Function

Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A) decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI), Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (p<0.05). The assessment of the first three parameters of the Fulg-Meyer scale and the evaluations of the motor part of the Functional Independence Measure showed statistically improvement until the end of the study. We conclude that proper choice of muscles and individualized doses of BT-A can improve function in selected post-stroke patients.

Perbedaan Skor Functional Independence Measure (FIM) pada Pasien Rawat Inap dengan Stroke Iskemik dan Stroke Hemoragik di Rumah Sakit di Kota Bengkulu Tahun 2018

2018 ◽  
Vol 1 (3) ◽  
pp. 163-175
Author(s):  
Panji Harry Priya Nugraha ◽  
Suryo Bantolo ◽  
Annelin Kurniati ◽  
Noor Diah Erlinawati ◽  
Ahmad Azmi Nasution
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Functional Independence Measure ◽  
Total Sample ◽  
Functional Independence ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Significant Difference ◽  
Score Gain ◽  
The Difference

Stroke is one of the most common causes of disability in the world. Patients with ischemic stroke have different functional improvements from patients with hemorrhagic stroke. The tool is the Functional Independence Measure (FIM) questionnaire. This study aims to determine the difference in FIM scores in hospitalized patients with ischemic stroke and hemorrhagic stroke at hospitals in Bengkulu City. This research is an observational analytic research with cross-sectional design. The study involved stroke patients who hospitalized at RS Bhayangkara Bengkulu City, RSUD Bengkulu City, and RSUD dr. M. Yunus Bengkulu City from January-April 2018 with total sample 22 ischemic stroke patients and 22 hemorrhagic stroke patients who met the inclusion criteria. FIM scores as independent variables, while the type of stroke as dependent variables. The difference between the two variables was analyzed by unpaired t test and Mann-Whitney test. Patients with ischemic stroke had admission FIM score higher than patients with hemorrhagic stroke (26 vs 13,5; p=0.006). There were no differences in discharge FIM score in patients in both types of stroke (1,67 vs 1,58; p=0,081). There was no difference in FIM score gain between patients with ischemic stroke and patients with hemorrhagic stroke (4,12 vs 4,36; p=0,444). Patients with ischemic stroke had higher admission FIM score compared to patients with hemorrhagic stroke, but there was no significant difference in FIM score gain during hospitalization between ischemic stroke and hemorrhagic stroke patients at hospitals in Bengkulu City.

Chronic Kidney Disease and Functional Outcomes 6 Months after Ischemic Stroke: A Prospective Multicenter Study

2015 ◽  
Vol 46 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Shin Yi Jang ◽  
Min Kyun Sohn ◽  
Jongmin Lee ◽  
Deog Young Kim ◽  
Sam-Gyu Lee ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Stroke Patients ◽  
Nihss Score ◽  
Disease Epidemiology ◽  
Post Stroke ◽  
Obesity Hypertension

Background: The aim of this study was to investigate whether chronic kidney disease (CKD) predicts the outcome of the Functional Independence Measure (FIM) and the Korean version of the modified Barthel Index (K-MBI) 6 months after stroke with adjustment for age, gender, education, smoking, drinking, obesity, hypertension, diabetes mellitus, dyslipidemia, the FIM or K-MBI at discharge and the National Institutes of Health Stroke Scale (NIHSS) score 7 days post stroke. Methods: This study is an interim report of the Korean Stroke Cohort for Functioning and Rehabilitation. The sample included 2,037 ischemic stroke patients aged 18 years or older. The FIM and K-MBI scores were assessed at discharge and at 6 months after the onset of stroke. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was defined as an eGFR <60 ml/min/1.73 m2. Results: Overall, the mean age was 65.5 (±12.4) years. The proportion of men was 62.6%. The proportion of CKD cases was 12.7%. The means of the 6-month FIM and K-MBI were 109.8 (±27.9) and 87.0 (±26.4), respectively. In multiple linear regressions, the 6-month FIM after stroke was significantly associated with CKD (-2.85, p < 0.05), age (-0.29, p < 0.01), the FIM at discharge (0.46, p < 0.01) and the 7-day NIHSS score (-1.71, p < 0.01). Additionally, the post-stroke 6-month K-MBI was significantly associated with CKD (-2.88, p < 0.01), age (-0.27, p < 0.01), the K-MBI at discharge (0.46, p < 0.01) and the 7-day NIHSS score (-1.55, p < 0.01). Conclusions: This nationwide hospital-based cohort study showed that CKD might predict poor 6-month FIM and K-MBI scores in ischemic stroke patients.

Development and Validation of Crosswalks Between FIM® and SCIM III for Voluntary Musculoskeletal Movement Functions

2021 ◽  
pp. 154596832110338
Author(s):  
Linda A. T. Jones ◽  
Chih-Ying Li ◽  
David Weitzenkamp ◽  
John Steeves ◽  
Susie Charlifue ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Functional Recovery ◽  
Systems Of Care ◽  
Functional Independence Measure ◽  
Correlation Coefficients ◽  
Functional Independence ◽  
Cord Injury ◽  
Parametric Analyses ◽  
Development And Validation

Background. In spinal cord injury, there are multiple databases containing information on functional recovery, but data cannot be pooled or compared due to differences in how function is measured. A crosswalk is needed to link or convert scores between instruments. Objectives. To create a crosswalk between the voluntary musculoskeletal movement items in the Functional Independence Measure (FIM®) and the Spinal Cord Independence Measure III (SCIM III) for spinal cord injury. Methods. Retrospective datasets with FIM® and SCIM III on the same people were used to develop (Swiss dataset, n = 662) and validate (US, n = 119, and Canadian datasets, n = 133) the crosswalks. Three different crosswalk methods (expert panel, equipercentile, and Rasch analysis) were employed. We used the correlation between observed scores on FIM® and SCIM III to crosswalked scores as the primary criterion to assess the strength of the crosswalk. Secondary criteria such as score distributions, Cohen’s effect size, point differences, and subgroup invariance were also evaluated. Results. All three methods resulted in strong correlation coefficients, exceeding the primary criterion value of r = .866 (.897–.972). Assessment of secondary criteria suggests the equipercentile and Rasch methods produced the strongest crosswalks. Conclusions. The Rasch FIM®/SCIM III crosswalk is recommended because it is based on co-calibration of linearized measures, allowing for more sophisticated parametric analyses. The crosswalk will allow comparisons of voluntary musculoskeletal functional recovery across international databases using different functional measures, as well as different systems of care and rehabilitation approaches.

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