Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult’s Function after Hip Fracture

This study aimed to examine the effect of a multidisciplinary tele-rehabilitation program on functional recovery of older adults with hip fracture compared with home-based in-person rehabilitation. In this single-blinded, non-randomized clinical trial, we included older with hip fracture. The tele-rehabilitation group received a 12-week tele-rehabilitation program (supervised by their family caregivers). The control group received the usual postoperative rehabilitation provided by the Andalusian health system (Spain). The primary outcome was the patient-reported functional status assessed with the Functional Independence Measure. We also measured performance-based functional recovery using the Timed Up and Go Test and Short Physical Performance Battery. We performed both a per-protocol (62 participants; 28 tele-rehabilitation and 34 control groups) and an intention-to-treat analysis (71 participants; 35 tele-rehabilitation and 36 control groups). Participants who used the tele-rehabilitation program had higher Functional Independence Measure scores (high effect size: 0.98 Cohen’s d; p < 0.001) and better performance in the Timed Up and Go Test (medium effect size: 0.63 Cohen’s d; p = 0.025) compared with the control group. Differences between groups post-intervention were not statistically significant in the Short Physical Performance Battery. The tele-rehabilitation intervention proposed in this study is a valuable treatment option in the recovery process for older adults with hip fracture. ClinicalTrials.gov Identifier: NCT02968589.

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The impact of movement rehabilitation on functional recovery to everyday activities in stroke patients – preliminary report

Physiotherapy and Health Activity ◽

10.1515/pha-2015-0011 ◽

2015 ◽

Vol 23 (1) ◽

pp. 23-28

Author(s):

Gabriela Walla ◽

Ewa Żmudzka-Wilczek ◽

Katarzyna Mazur ◽

Ryngier Paweł ◽

Agnieszka Nawrat-Szołtysik

Keyword(s):

Upper Extremity ◽

Functional Recovery ◽

Functional Independence ◽

Rehabilitation Program ◽

Control Group ◽

Study Group ◽

Timed Up And Go ◽

Everyday Activities ◽

Self Sufficiency ◽

The Impact

Abstract Background: The main objective of this study was to demonstrate the beneficial effects of rehabilitation on self-sufficiency and recovery to everyday activities in patients after stroke. Material/Methods: The study group comprised 20 patients (11 women and 9 men), who were randomly allocated into two groups of 10 participants each. The first was the control group whose members underwent a 3-week rehabilitation program used in the Neurological Department of the District Hospital in Zawiercie. The study group received the same rehabilitative program but enriched with selected elements of the Bobath concept. On the first and last days of the study each of the patients was assessed with respect to self-sufficiency in performing daily activities using Functional Measure ”Repty” (FMR - simplified version of Functional Independence Measure), upper extremity proximal motor control (the Frenchay Arm Test - FAT) and lower extremity strength (the Timed Up and Go Test - TUG). Results: The results revealed that patients with enriched rehabilitative program exhibited improvement in a greater numer of physical functions as assessed by the FMR (improvement by 26.4%) compared to the control participants (14.28%). The Frenchay Arm Test and the Timed Up and Go Test showed improvement in upper extremity control and locomotion in the study and control participants. The mean reduction in TUG time was 2.5 s and 3.4 s in the control and study participants, respectively; the results are statistically significant. A FAT task, ie., lifting a cylinder and replacing it improved by a mean of 2 and 0.5 inches; there were also gains in the performance of other tasks such as drinking water from a glass and combing hair. Conclusions: The final results revealed an improvement of physical function in all patients. However, rehabilitation program enrichment with selected elements of the Bobath concept helped the patients achieve better functional recovery; a 3-week rehabilitation program more effectively contributed to improving self-sufficiency, locomotion and arm function.

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Evaluation of Functional Recovery by Motor Functional Independence Measure Test of Elderly After Hip Fracture in Serbia

Acta Médica Portuguesa ◽

10.20344/amp.4267 ◽

2014 ◽

Vol 27 (1) ◽

pp. 88 ◽

Cited By ~ 1

Author(s):

Natasa Radosavljevic ◽

Dejan Nikolic ◽

Milica Lazovic ◽

Zoran Radosavljevic ◽

Aleksandar Jeremic

Keyword(s):

Hip Fracture ◽

Functional Recovery ◽

Age Groups ◽

Functional Independence Measure ◽

Severity Index ◽

Functional Independence ◽

Post Discharge ◽

Third Age ◽

Period 2 ◽

Group 2

Introduction: The aim of the study was to evaluate motor functional status measured by motor Functional Independence Measure (mFIM) test in population above 65 years of age after the hip fracture. Material and Methods: We evaluated 203 patients after hip fracture by mFIM test on 3 occasions: at admission (Period-1), at discharge (Period-2) and 3 months after discharge (Period-3); 3 age groups: Group65-74, Group75-84 and Group85-up and 2 groups concerning Severity Index (SI): group 0-1.99 (SI1) and group ≥ 2 (SI2). Results: In same SI group there is significant increase in mFIM values for Period-2 and Period-3 for both genders and in first two age groups, while for those above 85 years of age with higher SI we found non-significant change in mFIM values between discharge and 3 months post discharge period. Discussion: The most significant improvement is obtained for women in first and third age groups and with higher SI. Conclusion: Gender is not significant predictor for motor functional recovery measured by mFIM test in patients with hip fracture, although the admittance mFIM is a good indicator for mFIM capacity recovery in women of certain age groups (first and third age groups).

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Depressive Symptoms in Individuals after Stroke in a Home-Based Rehabilitation Setting

Neurology Research International ◽

10.1155/2018/1621830 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Julianne Vermeer ◽

Amanda McIntyre ◽

Shannon Janzen ◽

Danielle Rice ◽

Laura Allen ◽

...

Keyword(s):

Depressive Symptoms ◽

Functional Independence Measure ◽

Functional Independence ◽

Rehabilitation Program ◽

Poststroke Depression ◽

Rehabilitation Team ◽

Care Access ◽

Home Based ◽

Patient Health ◽

The Impact

Poststroke depression has been shown to affect rehabilitation progress. This study evaluated patients after stroke who actively participated in a home-based rehabilitation program to determine variables that correlated with depressive symptoms in this population. A retrospective review of patients who were provided rehabilitation by Community Stroke Rehabilitation Team clinicians between January 1, 2009, and September 30, 2015, was completed. Logistic regression analysis was conducted to determine which demographic and outcome variables (Functional Independence Measure [FIM™] and Reintegration to Normal Living Index [RNLI]) were independently associated with depressive symptoms, as defined by Patient Health Questionnaire (PHQ-9) scores. 889 patients (53.2% male, mean age = 69.8 years) were included. Based on PHQ-9 scores, 89.7% of patients presented with no or mild depressive symptoms (PHQ-9 < 10) and 10.3% were considered to have moderate to severe depressive symptoms (PHQ-9 ≥ 10). The regression demonstrated that referral from outpatient, community care access centre, or community settings (OR = 1.89, p=0.04), low RNLI scores (OR = 0.92; p=0.001), and younger age (OR = 0.96; p<0.001) predicted patients having moderate to severe depressive symptoms. Given the impact of poststroke depression on rehabilitation, clinicians should consider the potential impact of referral source, community reintegration, and age when monitoring and treating depressive symptoms.

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Correlation of cardiovascular and respiratory comorbidities with motor functional independence in the elderly after hip fracture

Medicinski pregled ◽

10.2298/mpns2102020r ◽

2021 ◽

Vol 74 (1-2) ◽

pp. 20-24

Author(s):

Natasa Radosavljevic ◽

Dejan Nikolic ◽

Sofija Radosavljevic ◽

Mirko Grajic ◽

Ksenija Boskovic

Keyword(s):

Hip Fracture ◽

Rating Scale ◽

Functional Independence Measure ◽

Severity Index ◽

The Elderly ◽

Functional Independence ◽

Rehabilitation Program ◽

Significant Difference ◽

Different Levels

Introduction. The aim of the study was to evaluate the correlation between different levels of examined comorbidities using the Cumulative Illness Rating Scale for Geriatrics and motor Functional Independence Measure test in the elderly after hip fracture. Material and Methods. The study included 203 geriatric patients, 65 years of age and older, who were referred to a rehabilitation program at the Institute for Rehabilitation after hip fracture. The following comorbidities were analyzed: cardiac, vascular, and respiratory. The motor component of Functional Independence Measure was used to assess functional recovery. The Cumulative Illness Rating Scale for Geriatrics was used to calculate the comorbidity index. The patients were assessed on 4 different occasions: on admission, on discharge, 3 months after discharge, and 6 months after discharge. The short-term and long-term efficiency of rehabilitation treatment was measured. Results. There is a significant difference in motor Functional Independence Measure scores between different levels of vascular (p = 0.010) and respiratory (p = 0.047) comorbidities only on admission, while at other times of observation no significant difference (p > 0.05) was found. The highest level of correlation was found in level 3 comorbidity severity index for cardiac comorbidity (discharge/3 months) (Pearson?s correlation - R = 0.938) and vascular comorbidity (discharge/3 months) (R = 0.912), and level 2 comorbidity severity index for respiratory comorbidity (discharge/3 months) (R = 0.941). Conclusion. Rehabilitation treatment of the elderly after hip fracture plays a significant role both in short-term and long-term recovery, particularly in the functional domains even in persons with significant comorbidities. Early inclusion and an individually designed rehabilitation program with continuous monitoring of the elderly after hip fractures results in functional improvement and better quality of life.

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Strategies to Support Physical Activity Participation in Older Adults With Heart Failure

Innovation in Aging ◽

10.1093/geroni/igaa057.1469 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 454-454

Author(s):

Katherine Hall ◽

Amy Pastva ◽

Heather King ◽

Sean Lowers ◽

Julie Miller ◽

...

Keyword(s):

Physical Activity ◽

Heart Failure ◽

Older Adults ◽

Exercise Program ◽

Functional Independence ◽

Rehabilitation Program ◽

Exercise Rehabilitation ◽

Supervised Exercise ◽

Home Based ◽

Health Burdens

Abstract Physical activity (PA) is recommended for people living with heart failure (HF). Despite evidence of its benefits, participation in PA is low in this population, putting them at risk for loss of functional independence and additional health burdens. The aim of this pilot study was to ask older adults living with stable, chronic HF to identify strategies to support regular PA. Patients in an outpatient HF rehabilitation program were recruited to participate in focus groups about their PA knowledge, attitudes, and preferences as part of a stakeholder engagement project. At the beginning of the focus group, participants completed a questionnaire listing 8 potential strategies to optimize PA, and were asked to identify the top 4 strategies that they thought would be most beneficial to support regular PA participation. This was the focus of the current analysis. Thirteen adults with HF (M age=65; 46% female; 62% African American; M BMI=32.6 kg/m2) were enrolled. Top-rated strategies endorsed by participants to support long-term adherence to PA included provision of an exercise guide to support home-based exercise and supplement health provider-supervised exercise sessions (69%), group education classes (64%), completion of fitness assessments at regular intervals (62%), and provision of a transition pathway from an exercise rehabilitation program to a community-based exercise program (62%). The remaining strategies were endorsed by fewer than 50% of participants, and included remote delivery and support options. These results have important implications for future program development and implementation efforts to support PA among older adults with stable, chronic HF.

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Early home-supported discharge for patients with stroke in Portugal: a randomised controlled trial

Clinical Rehabilitation ◽

10.1177/0269215515627282 ◽

2016 ◽

Vol 31 (2) ◽

pp. 197-206 ◽

Cited By ~ 9

Author(s):

Silvina Santana ◽

José Rente ◽

Conceição Neves ◽

Patrícia Redondo ◽

Nina Szczygiel ◽

...

Keyword(s):

Stroke Unit ◽

Controlled Trial ◽

Functional Independence Measure ◽

Functional Independence ◽

Primary Outcome Measure ◽

Control Group ◽

Stroke Patients ◽

Control Groups ◽

Open Label

Objective: To evaluate an early home-supported discharge service for stroke patients. Design: We carried out a prospective, randomised, open-label, blinded-endpoint trial (allocation ratio of 1:1) with patients assigned to either an early home-supported discharge service or usual care. Setting: The study was undertaken in Aveiro, Portugal, between April 2009 and April 2013. Subjects: We included stroke patients aged 25–85 years admitted to the stroke unit with an initial Functional Independence Measure of up to 100, who gave informed consent. Interventions: Patients in the early home-supported discharge group began their rehabilitation intervention in the stroke unit and the early home-supported discharge team worked with them at home for a maximum of one month. Patients in the control group received usual services. Main measures: The primary outcome measure was the Functional Independence Measure at six months after stroke. Results: We randomised 190 patients of whom 34 were lost to follow-up. There were no significant differences (p > 0.5) in the average scores of Functional Independence Measure between the early home-supported discharge (69 ±22; mean ±SD) and the control groups (71 ±17) measured at baseline; and between the early home-supported discharge (107 ±20) and the control groups (107 ±25) measured at six months. The number of individuals with a low Functional Independence Measure score (<60) in the early home-supported discharge group compared with the control group was higher at admission (34/95 vs. 26/95) and lower at follow-up (2/74 vs. 5/78). Conclusions: It was feasible to implement early home-supported discharge procedures in a Southern European setting, but we have not shown convincing differences in disability at six months.

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Effectiveness of Robot-Assisted Gait Training on Functional Skills in Children with Cerebral Palsy

Journal of Pediatric Neurology ◽

10.1055/s-0041-1725128 ◽

2021 ◽

Author(s):

Burak Yaşar ◽

Emine Atıcı ◽

Derya Azim Razaei ◽

Tülay Çevik Saldıran

Keyword(s):

Cerebral Palsy ◽

Functional Independence Measure ◽

Gait Training ◽

Functional Independence ◽

Rehabilitation Program ◽

Robot Assisted ◽

Timed Up And Go ◽

Motor Functions ◽

Significant Difference ◽

Children With Cerebral Palsy

AbstractThis study was aimed to investigate the effects of robot-assisted gait training (RAGT) on motor functions, spasticity status, balance, and functionality in children with cerebral palsy (CP). A total of 26 patients who were diagnosed with CP (diplegic, with gross motor function classification system [GMFCS] levels of 2–5) and who regularly participated in a rehabilitation program were recruited in the study after obtaining approval from their parents. The patients were randomly assigned to two groups. Group 1 (n = 13) received conventional physical therapy (65 minutes, 2 days/week × 8) and group 2 (n = 13) received 25 minutes of RAGT (RoboGait) in addition to conventional therapy (CT; 40 minutes, 2 days/week × 8). GMFCS was used to evaluate motor functions and the Modified Ashworth Scale was used to evaluate spasticity. The pediatric Berg balance scale, pediatric functional independence measure, and timed up and go tests were employed to assess balance and functional status. The evaluations were performed at baseline and after 8 weeks of therapy. Both rehabilitation methods led to a statistically significant decrease in spasticity (p < 0.05); however, there was no difference in this improvement of spasticity between the groups (p > 0.05). Both groups exhibited significant improvements in functional independence, balance, and performance at the end of therapy (p < 0.05), and there was no significant difference between the groups (p > 0.05). The results of this study show that addition of RAGT to CT for 8 weeks is not superior to CT alone in children with CP.

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EFFECTIVENESS OF ROBOTIC-ASSISTED GAIT TRAINING IN STROKE REHABILITATION: REVOLUTION IN PATIENT OUTCOME

International Journal of Advanced Research ◽

10.21474/ijar01/13216 ◽

2021 ◽

Vol 9 (07) ◽

pp. 1079-1087

Author(s):

Amjad Annethattil ◽

◽

Joseph Prabahar Pushparaj ◽

Ayman Sabbagh ◽

Mohammad Farraj ◽

...

Keyword(s):

Outcome Measures ◽

Stroke Rehabilitation ◽

Functional Independence Measure ◽

Gait Training ◽

Functional Independence ◽

Berg Balance Scale ◽

Rehabilitation Program ◽

P Value ◽

Timed Up And Go ◽

Robotic Assisted

Objective: To evaluate the effectiveness of robotic-assisted gait training (RAGT) in improving the functional outcomes among stroke survivors Design: Retrospective matched control study. Setting: Inpatients stroke unit, Qatar Rehabilitation Institute. Outcome Measures: The Functional Ambulation classification (FAC), The Functional independence measure (FIM), The Berg Balance Scale (BBS), The Dynamic Gait index (DGI), The Ten-meter walk test (10MWT), The timed up and Go test (TUG) and the Five times sit to stand (5XSTS) Data Analysis: A retrospective comparison of stroke patients who received robotic assisted gait training performed statistically using the 20th version of SPSS statistical package (SPSS Inc. Chicago, IL, USA) Study Procedures: The investigators reviewed the medical records, the physiotherapy treatment sessions records and data from the Clinical Management System of Qatar rehabilitation institute of the patients during the period from 1stJanuary 2018 to 31 December 2019. RAGT group was created to assign the patients who received more than four RAGT sessions. The other group was created from the patients who completed the stroke rehabilitation program without RAGT to cross match Conclusion: All the outcome measures were compared between admission and discharge regardless of their group and found that there was a good improvement in the outcome and statistically significant (p value 0.0001) While comparing the lokomat and non lokomat group in functional outcome measurements lokomat group (RAGT) had significant improvement in discharge scores.

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Efficacy of a Training on Executive Functions in Potentiating Rehabilitation Effects in Stroke Patients

Brain Sciences ◽

10.3390/brainsci11081002 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1002

Author(s):

Vincenza Tarantino ◽

Francesca Burgio ◽

Roberta Toffano ◽

Elena Rigon ◽

Francesca Meneghello ◽

...

Keyword(s):

Executive Functions ◽

Functional Independence Measure ◽

Training Group ◽

Functional Independence ◽

Rehabilitation Program ◽

Functional Improvement ◽

Control Group ◽

Stroke Patients ◽

Treatment As Usual ◽

Wide Range

Cognitive impairment after a stroke has a direct impact on patients’ disability. In particular, impairment of Executive Functions (EFs) interferes with re-adaptation to daily life. The aim of this study was to explore whether adding a computer-based training on EFs to an ordinary rehabilitation program, regardless of the specific brain damage and clinical impairment (motor, language, or cognitive), could improve rehabilitation outcomes in patients with stroke. An EF training was designed to have minimal motor and expressive language demands and to be applied to a wide range of clinical conditions. A total of 37 stroke patients were randomly assigned to two groups: a training group, which performed the EF training in addition to the ordinary rehabilitation program (treatment as usual), and a control group, which performed the ordinary rehabilitation exclusively. Both groups were assessed before and after the rehabilitation program on neuropsychological tests covering multiple cognitive domains, and on functional scales (Barthel index, Functional Independence Measure). The results showed that only patients who received the training improved their scores on the Attentional Matrices and Phonemic Fluency tests after the rehabilitation program. Moreover, they showed a greater functional improvement in the Barthel scale as well. These results suggest that combining an EF training with an ordinary rehabilitation program potentiates beneficial effects of the latter, especially in promoting independence in activities of daily living.

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Adipokines as Potential Biomarkers in the Neurorehabilitation of Obese Stroke Patients

Current Neurovascular Research ◽

10.2174/1567202617666200603150901 ◽

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.

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