Abstract:
:Current assessments do not provide reliable factors predictive of outcome from stroke for stroke survivors of intermediate age and severity of deficit. We sought to investigate whether early rate of functional improvement can facilitate prediction of functional outcome, length of stay, and disposition beyond that afforded by age and initial severity of deficit. Prospective study of consecutive admissions to acute rehabilitation (N = 244) with diagnosis of ischemic or hemorrhagic stroke. Independent measures were age, marital status, living situation, social situation, lag from symptom onset to rehabilitation, stroke type, admission score on the Functional Independence Measure (FIM), rate of FIM change (ROFC) as assessed by the best weekly FIM change in the first 3 weeks of rehabilitation. Dependent measures were functional status on discharge as assessed by a modification of Steinman's method, length of stay, and discharge disposition. Logistic regression analyses on each of the dependent measures identified significant factors, and interactions of significant factors were assessed by analysis of variance on continuous dependent variables. Cross-tabulations using significant factors from the logistic regression analyses were performed to identify groups with homogeneous outcomes. Groups with >80% homogeneity were considered likely to have predictive value. Discharge functional status: Admission FIM (AFIM) again fractionated the population into groups with poor outcome (AFIM <50 remained dependent), good outcome (AFIM >70 achieved nondependence), and an intermediate group with unpredictable outcome. In this intermediate group, ROFC had significant effect only for a small number of patients (n = 9) with rapid improvement (ROFC >25) who achieved nondependence. LOS: AFIM >70 had less than average LOS, ROFC = 10-15 FIM/week had longer than average LOS. LOS was significantly prolonged in patients with poor outcomes. Disposition: AFIM >70 and age <60 were strongly associated with home discharge. Patients not living at home before admission were not discharged home. Married patients had a greater tendency to home discharge than did those not married. ROFC had no bearing on disposition. ROFC has an independent influence on outcome but was sufficiently powerful in our sample to identify reliably only a very small subset of patients with otherwise indeterminate prognosis. LOS seems inordinately prolonged in patients with poor outcomes. Both of these results can guide efficient rehabilitation management.
journal_name
Neurorehabil Neural Repairjournal_title
Neurorehabilitation and neural repairauthors
Ween JE,Mernoff ST,Alexander MPdoi
10.1177/154596830001400309keywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
229-35issue
3eissn
1545-9683issn
1552-6844journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Individuals with stroke often sustain bone loss on the hemiparetic side and are prone to fragility fractures. Exercise training may be a viable way to promote bone mineral density (BMD) and geometry in this population. OBJECTIVE:This was a pilot study to evaluate the effects of a 6-month treadmill exercise ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968309353326
更新日期:2010-05-01 00:00:00
abstract::Partnered tango dance can improve balance and gait in individuals with Parkinson's disease (PD). Partnered dance may allow these individuals to challenge balance more than nonpartnered dance. Alternatively, partnered practice could reduce balance gains because the participant may rely on the partner as a balance aid w...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968309353329
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:The slow rate of nerve regeneration following injury can cause extended muscle denervation, leading to irreversible muscle atrophy, fibrosis, and destruction of motor endplates. The immunosuppressant FK506 (tacrolimus) has been shown to accelerate the rate of nerve regeneration and functional recovery. Howev...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968311431965
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to establish the minimal detectable change (MDC) and clinically important differences (CIDs) of the physical domains of the Stroke Impact Scale (SIS) and to assess the proportions of patients' change scores exceeding the MDC and CIDs after stroke rehabilitation. METHODS:Seventy...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968309356295
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Low-frequency repetitive transcranial magnetic stimulation (rTMS) over the unaffected motor cortex may improve motor function of the paretic hand after stroke. However, low-frequency rTMS might adversely affect bimanual movement by decreasing transcallosal function. OBJECTIVE:The authors investigated whethe...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968311433295
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Poststroke functional outcome and discharge disposition are influenced by age, lesion location and size, severity of neurological insult, prior functional ability, and social support. The effect of admission ambulation velocity on length of stay and discharge disposition has not been previously r...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968304272762
更新日期:2005-03-01 00:00:00
abstract::Background. Motoneuron loss is a severe medical problem that can result in loss of motor control and eventually death. We have previously demonstrated that partial motoneuron loss can result in dendritic atrophy and functional deficits in nearby surviving motoneurons, and that treatment with androgens can be neuroprot...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968319860485
更新日期:2019-08-01 00:00:00
abstract::Background. After stroke, recovery of movement in proximal and distal upper extremity (UE) muscles appears to follow different time courses, suggesting differences in their neural substrates. Objective. We sought to determine if presence or absence of motor evoked potentials (MEPs) differentially influences recovery o...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968319850138
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:There are indications that perilesional and remote peripheral motor axons may degenerate after spinal cord injury (SCI). The authors investigated the magnitude and dependence on severity of SCI of this degeneration as well as whether motor axons so affected can recover. METHODS:The function of the peripheral...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,多中心研究
doi:10.1177/1545968310368534
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Functional electrical stimulation therapy (FET) has a potential to improve voluntary grasping among individuals with tetraplegia secondary to traumatic spinal cord injury (SCI). OBJECTIVE:This single-site, randomized controlled trial examined the efficacy of 40 hours of FET with conventional occupational th...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968310392924
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Stroke patients manifest steering difficulties during walking, which may arise from an altered perception of visual motion. OBJECTIVE:To examine the ability of stroke patients to control their heading direction while walking in a virtual environment (VE) describing translational optic flows (OFs) expanding ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968309355985
更新日期:2010-06-01 00:00:00
abstract::One in 2 Canadians is expected to acquire cancer in their lifetime. Many cancers, including breast, ovarian, and lung cancer, are treated using taxane chemotherapy with curative intent. A major adverse effect with the use of taxane chemotherapeutic agents is taxane-induced peripheral neuropathy (TIPN). Both positive (...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,评审
doi:10.1177/1545968319860486
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Individuals with unilateral vestibular hypofunction (UVH) alter their movement and reduce mobility to try to stabilize their gaze and avoid symptoms of dizziness and vertigo. OBJECTIVE:To determine if individuals with UVH 6 weeks after surgery demonstrate altered head and trunk kinematics during community a...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968318770271
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:In hemiplegic gait, step length typically differs in magnitude between paretic and nonparetic sides. However, the direction of step-length asymmetry varies across stroke patients. OBJECTIVE:The study sought to understand directional variations in step-length asymmetry in terms of asymmetries in forward foot...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968310380687
更新日期:2011-03-01 00:00:00
abstract::A major problem in neurorehabilitation is the lack of objective outcomes to measure movement quality. Movement quality features, such as coordination and stability, are essential for everyday motor actions. These features allow reacting to continuously changing environment or to resist external perturbations. Neurolog...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968320969936
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Music listening conveys beneficial effects on cognitive processes in both normal and pathologic cerebral functioning. Surprisingly, no quantitative study has evaluated the potential effects of music on cognition and consciousness in patients with disorders of consciousness. OBJECTIVE:The aim of the present ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968314565464
更新日期:2015-09-01 00:00:00
abstract::The Wolf Motor Function Test (WMFT) has been used in rehabilitation studies of chronic stroke patients, but until now its psychometric properties have not been evaluated in patients with subacute stroke. Two hundred twenty-nine participants with subacute stroke (3-9 months postinjury) at 7 research sites met inclusion...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968305276663
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Gait impairments after stroke arise from dysfunction of one or several features of the walking pattern. Traditional rehabilitation practice focuses on improving one component at a time, which may leave certain features unaddressed or prolong rehabilitation time. Recent work shows that neurologically intact a...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968318792623
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Some noninvasive brain-computer interface (BCI) systems are currently available for locked-in syndrome (LIS) but none have incorporated a statistical language model during text generation. OBJECTIVE:To begin to address the communication needs of individuals with LIS using a noninvasive BCI that involves rap...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968313516867
更新日期:2014-05-01 00:00:00
abstract::Neuroplasticity is critical for learning, memory, and recovery of lost function following neurological damage. Noninvasive brain stimulation (NIBS) techniques can induce neuroplastic changes in the human cortex that are behaviorally relevant, raising the exciting possibility that these techniques might be therapeutica...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968314562649
更新日期:2015-09-01 00:00:00
abstract:PURPOSE:Walking speed is a cardinal indicator of poststroke gait performance; however, no consensus exists regarding the optimal treatment method(s) for its enhancement. The most widely accepted criterion for establishing the contribution of treatment to walking speed is the gain in speed. The actual speed, however, at...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,评审
doi:10.1177/1545968308315997
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:To investigate the effectiveness of upper limb rehabilitation, sound measures of upper limb function, capacity, and performance are paramount. OBJECTIVES:This systematic review investigates reliability and responsiveness of upper limb measurement tools used in pediatric neurorehabilitation. METHODS:A 2-tie...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,评审
doi:10.1177/1545968315583723
更新日期:2016-01-01 00:00:00
abstract::Stroke recovery research involves distinct biological and clinical targets compared to the study of acute stroke. Guidelines are proposed for the pre-clinical modeling of stroke recovery and for the alignment of pre-clinical studies to clinical trials in stroke recovery. ...
journal_title:Neurorehabilitation and neural repair
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1177/1545968317724285
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:There is a need to identify reliable biomarkers of spinal cord injury recovery for clinical practice and clinical trials. OBJECTIVE:Our objective was to correlate serum albumin levels with spinal cord injury neurological outcomes. METHODS:We performed a secondary analysis of patients with traumatic spinal ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968317746781
更新日期:2018-01-01 00:00:00
abstract::Background. Understanding the factors that influence language recovery in aphasia is important for improving prognosis and treatment. Chronic comprehension impairments in Wernicke's aphasia (WA) are associated with impairments in auditory and phonological processing, compounded by semantic and executive difficulties. ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968319868709
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Step length asymmetry (SLA) is a common hallmark of gait poststroke. Though conventionally viewed as a spatial deficit, SLA can result from differences in where the feet are placed relative to the body (step position strategy), the timing between foot strikes (step time strategy), or the velocity of the body...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968314567149
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The neural correlates of training-induced improvements of cognitive functions after brain damage remain still scarcely understood. In the specific case of aphasia, although several investigations have addressed the issue of the neural substrates of functional recovery, only a few studies have attempted to as...
journal_title:Neurorehabilitation and neural repair
pub_type: 临床试验,杂志文章
doi:10.1177/1545968306294735
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Interfacing an amputee's upper-extremity stump nerves to control a robotic hand requires training of the individual and algorithms to process interactions between cortical and peripheral signals. OBJECTIVE:To evaluate for the first time whether EEG-driven analysis of peripheral neural signals as an amputee ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968311408919
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Bell's palsy (BP) is the most frequent form of peripheral palsy of the facial nerve. Prognosis for recovery is good for most patients; in the remaining cases, different grades of residual impairment persist. Physical therapy, in association with drug administration, aims to improve outcomes. OBJECTIVE:To as...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968313481280
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Although functional imaging and neurophysiological approaches reveal alterations in motor and premotor areas after stroke, insights into neurobiological events underlying these alterations are limited in human studies. OBJECTIVE:We tested whether cerebral metabolites related to neuronal and glial compartmen...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968312469835
更新日期:2013-06-01 00:00:00