BRAIN-CONNECTS: Intensive Rehabilitation Program for Subacute Stroke Patients in an Inpatient Rehabilitation Facility

2019 ◽  
Author(s):  
Keyword(s):  
Inpatient Rehabilitation ◽  
Rehabilitation Program ◽  
Stroke Patients ◽  
Rehabilitation Facility ◽  
Subacute Stroke ◽  
Inpatient Rehabilitation Facility ◽  
Intensive Rehabilitation

scholarly journals Intensive rehabilitation programme for patients with subacute stroke in an inpatient rehabilitation facility: describing a protocol of a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e046346
Author(s):  
Monique Messaggi Sartor ◽  
Jennifer Grau-Sánchez ◽  
Anna Guillén-Solà ◽  
Roser Boza ◽  
Josep Puig ◽  
...  
Keyword(s):  
Cohort Study ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Programme ◽  
Research Committee ◽  
Rehabilitation Unit ◽  
Rehabilitation Facility ◽  
Subacute Stroke ◽  
Inpatient Rehabilitation Facility ◽  
Therapy Sessions ◽  
Intensive Rehabilitation

IntroductionRehabilitation is recognised as a cornerstone of multidisciplinary stroke care. Intensity of therapy is related to functional recovery although there is high variability on the amount of time and techniques applied in therapy sessions. There is a need to better describe stroke rehabilitation protocols to develop a better understanding of current practice increasing the internal validity and generalisation of clinical trial results. The aim of this study is to describe an intensive rehabilitation programme for patients with stroke in an inpatient rehabilitation facility, measuring the amount and type of therapies (physical, occupational and speech therapy) provided and reporting functional outcomes.Methods and analysisThis will be a prospective observational cohort study of patients with subacute stroke admitted to our inpatient rehabilitation facility during 2 years. A therapy recording tool was developed in order to describe the rehabilitation interventions performed in our unit. This tool was designed using the Delphi method, literature search and collaboration with senior clinicians. Therapists will record the time spent on different activities available in our unit during specific therapy sessions. Afterwards, the total time spent in each activity, and the total rehabilitation time for all activities, will be averaged for all patients. Outcome variables were divided into three different domains: body structure and function outcomes, activity outcomes and participation outcomes and will be assessed at baseline (admission at the rehabilitation unit), at discharge from the rehabilitation unit and at 3 and 6 months after stroke.Ethics and disseminationThis study was approved by the Medical Research Committee at Hospital del Mar Research Institute (Project ID: 34/C/2017). The results of this study will be presented at national and international congress and submitted for publication in peer-reviewed journals.Trial registration numberNCT04191109.

Comparison of the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) and the Barthel Index in stroke patients

2019 ◽  
Vol 33 (10) ◽  
pp. 1672-1681 ◽  
Author(s):  
Winke van Meijeren-Pont ◽  
Gerard Volker ◽  
Thea Vliet Vlieland ◽  
Paulien Goossens
Keyword(s):  
Observational Study ◽  
Effect Size ◽  
Barthel Index ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Stroke Patients ◽  
Discharge Data ◽  
Rehabilitation Facility ◽  
Inpatient Rehabilitation Facility ◽  
The Mean

Objective: To compare the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) to the responsiveness of the Barthel Index in stroke patients in an inpatient rehabilitation facility. Design: Observational study. Setting: Inpatient rehabilitation facility. Subjects: Consecutive stroke patients admitted for clinical rehabilitation. Interventions: Not applicable. Main measures: The USER and the Barthel Index were administered by a nurse at admission and discharge. The Effect Size and Standardized Response Mean (SRM) were calculated as measures of responsiveness. Results: From 198 (78%) of the 254 patients who were included in the study period, both admission and discharge data were available. At admission the mean score of the USER subscale Functional independence was 43.1 ( SD = 18.9) and at discharge the mean score was 59.3 ( SD = 13.8). The mean score of the Barthel Index at admission was 13.3 ( SD = 5.4) and at discharge 18.4 ( SD = 3.3). The Effect Size of the USER subscales Mobility, Self-care, Cognitive functioning, Pain, Fatigue and Mood were 0.85, 0.77, 0.48, 0.19, 0.40 and 0.28, respectively, and of the Barthel Index 0.94. The results for the SRM were in the same range. Conclusion: In inpatient rehabilitation after stroke, the USER was less responsive than the Barthel Index.

Abstract TMP47: Impact of Medicare Reform on Inpatient Rehabilitation Facility Access for Hemorrhagic Stroke Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Nneka L Ifejika ◽  
Farhaan Vahidy ◽  
Mathew Reeves ◽  
Xian Ying ◽  
Roland Matsouaka ◽  
...  
Keyword(s):  
Skilled Nursing Facility ◽  
Inpatient Rehabilitation ◽  
Prospective Payment System ◽  
Sensitivity Analyses ◽  
Teaching Hospitals ◽  
Admission Criteria ◽  
Stroke Patients ◽  
Rehabilitation Facility ◽  
Inpatient Rehabilitation Facility ◽  
The Impact

Introduction: There is growing evidence that ICH patients make larger & faster recovery gains compared to ischemic stroke patients. Inpatient rehabilitation facility (IRF) care can significantly facilitate improvement. In 2010, changes to IRF admission criteria potentially restricted access. We hypothesize the Centers for Medicare and Medicaid Services (CMS) 2010 IRF Prospective Payment System Rule decreased IRF access & increased skilled nursing facility (SNF) utilization in ICH patients. Methods: The proportion of ICH survivors discharged to IRF, SNF or home was estimated using GWTG-Stroke data between 1/1/2008 & 12/31/2015 (n=265,444). Two binary hierarchical models determined the association between the 1/1/2010 CMS admission criteria change for IRFs and discharge setting, adjusting for patient & hospital characteristics. Subgroup analyses evaluated the effects of age, region & hospital type. Sensitivity analyses used complete NIHSS data (≈49%). Results: The prevalence of the 3 discharge destinations changed significantly over time (CMH row-mean-score P<0.0001; Figure 1). IRF rehab odds decreased and SNF rehab odds increased for ICH patients compared to home after the CMS 2010 IRF PPS Rule (Figure 2a & 2b). Decreased IRF rehab odds were found in patients age<65, Western US location or at non-teaching hospitals (Figure 2a). Increased SNF rehab odds were found in patients age≥65, Midwest location or at teaching hospitals (Figure 2b). Conclusions: IRF Rehab odds decreased and SNF rehab odds increased during the time period after CMS 2010 IRF PPS Rule implementation in ICH patients. The impact of such legislative changes on patient outcomes warrants further study.

scholarly journals Relationship between Serum BDNF Levels and Depressive Mood in Subacute Stroke Patients: A Preliminary Study

2018 ◽  
Vol 19 (10) ◽  
pp. 3131 ◽  
Author(s):  
Won Chang ◽  
Min Shin ◽  
Ahee Lee ◽  
Heegoo Kim ◽  
Yun-Hee Kim
Keyword(s):  
Short Form ◽  
Pearson Correlation ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Depressive Mood ◽  
Rehabilitation Program ◽  
Stroke Patients ◽  
Subacute Stroke ◽  
Preliminary Study ◽  
Serum Bdnf

The aim of this preliminary study was to investigate the potential of serum brain-derived neurotrophic factor (BDNF) as a biomarker in poststroke depressive mood in subacute stroke patients. Thirty-eight subacute stroke patients were recruited in this study. All participants underwent the standard rehabilitation program that included 2 h of physical therapy daily and 1 h of occupational therapy five days a week. The rehabilitation period lasted two weeks during the subacute stroke phase. We measured the serum BDNF, proBDNF, and matrix metalloproteinase-9 before and one and two weeks after the standard rehabilitation program. In addition, all participants were assessed using the Geriatric Depression Scale-Short Form (GDS-SF) for depressive mood at three time points. Pearson correlation analysis was performed to determine the relationship between serum BDNF levels and the GDS-SF. The GDS-SF showed significant improvement during the standard rehabilitation program period (p < 0.05). The GDS-SF was significantly correlated with serum BDNF levels at each time point (p < 0.05). These results suggest that serum BDNF may be used as a biomarker for depressive mood in subacute stroke patients. However, further studies with larger study populations are needed to clarify these results.

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