Abstract:
OBJECTIVE:To determine the feasibility and utility of applying a case-mix adjusted algorithm for treatment across the continuum of stroke rehabilitation. DESIGN:Implementation of a clinical algorithm developed through national expert panels to standardize rehabilitation assessment and treatment of veterans with stroke. Stroke patients were stratified into initial severity groups using FIM instrument-Function Related Groups (FIM-FRG) classifications and were followed up from first rehabilitation referral to completion of all active restorative functional goals. FIM-FRG assignments were used to establish case-mix adjusted outcome indicators for the continuum of rehabilitation services. SETTING:Rehabilitation services in medical and surgical units, intermediate care units, inpatient rehabilitation bed units, and outpatient settings in 10 participating Veterans Affairs (VA) medical centers. PATIENTS:Stroke patients (n = 421) who received rehabilitation in the 10 participating VA centers. MAIN OUTCOME MEASURES:Patients' functional gains, length of treatment (LOT), functional status at discharge, LOT efficiency, costs, cost efficiency, and disposition location. RESULTS:Two hundred twenty-three patients began rehabilitation while in acute medical or surgical units, 171 in inpatient rehabilitation units, 24 in intermediate care, and the remainder while in other settings. With cases compiled across all settings, average total rehabilitation costs for patients in the lowest FRG class (most severe disabilities) were more than twice those for patients assigned to the highest FRG class (least severe disabilities). FIM gains were greatest in the subset of younger stroke patients with the most severe disabilities. CONCLUSIONS:Implementing a standard algorithm of rehabilitation care that includes outcome indicators adjusted to patients' disability severity is feasible. The algorithm's utility is evident because it encompasses rehabilitation care provided across the full continuum, promotes access to care by advocating assessment of all stroke patients, encourages early initiation of treatment, and promotes a smooth transition though various levels of care while encouraging cost containment.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Bates BE,Stineman MGdoi
10.1053/apmr.2000.17808subject
Has Abstractpub_date
2000-11-01 00:00:00pages
1468-78issue
11eissn
0003-9993issn
1532-821Xpii
S0003-9993(00)92357-8journal_volume
81pub_type
杂志文章,多中心研究abstract::A case is presented of a woman who had an occlusive stroke at age 29. She was seen in a rehabilitation medicine clinic for central nervous system-mediated pain that had developed soon after a cerebrovascular event. After an extensive workup to find the cause of her cerebrovascular occlusion, it was discovered that she...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(98)90018-1
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment. DESIGN:Prospective clinical pilot study. SETTING:Education and research hospital. PARTICIPANTS:Women with a diagnosis of lymphedema secondary to breast cancer ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2016.02.019
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To investigate the changes in muscle oxygen consumption (mV˙O2) using near-infrared spectroscopy (NIRS) after 4 weeks of training with functional electrical stimulation (FES) cycling in nonambulatory people with multiple sclerosis (MS). DESIGN:Four-week before-after trial to assess changes in mV˙O2 after an ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2014.10.010
更新日期:2015-04-01 00:00:00
abstract::Understanding the use of weights in the analysis of data from multistage surveys. Large national surveys are powerful tools with which to examine a variety of important rehabilitation-related issues and are currently the only feasible method to study disability trends over time. Because it is impractical to draw simpl...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2005.09.021
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To determine and validate correction factors necessary to ensure consistent dosage of 1MHz ultrasound when applied in water at different applicator-to-skin distances and different levels of intensity. DESIGN:An intervention study with a crossover design. SETTING:A laboratory. PARTICIPANTS:Cross-sections of...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(96)90142-2
更新日期:1996-11-01 00:00:00
abstract::After multiple hospital admissions and an inpatient rehabilitation stay, a 68-year-old woman was transferred to our rehabilitation facility with a paraparesis of unknown etiology. Previous studies included four CT scans and three MRIs which did not demonstrate the lesion. A myelogram was noncharacteristic. The correct...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:To demonstrate naturalistic motor control speed, coordinated grasp, and carryover from trained to novel objects by an individual with tetraplegia using a brain-computer interface (BCI)-controlled neuroprosthetic. DESIGN:Phase I trial for an intracortical BCI integrated with forearm functional electrical stim...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2018.07.445
更新日期:2019-07-01 00:00:00
abstract::This study compared the time of recovery at the zone of injury between motor complete (Frankel A and B) and motor incomplete (Frankel C and D) cervical spinal cord injured patients for the biceps (C5), extensor carpi radialis (C6), and triceps (C7) muscles. Manual muscle testing was performed initially three to seven ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:To identify unique predictors of the ability to return to living alone in geriatric patients undergoing medical rehabilitation. DESIGN:Of 900 consecutive geriatric patients entering medical rehabilitation, 372 were identified as living alone before admission. Data were collected on functional status, cogniti...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(97)90085-x
更新日期:1997-07-01 00:00:00
abstract::Persons experiencing recent onset of stroke show wide variation in their adjustment process. This study evaluates how much these individual differences are a function of interpersonal needs for social contact after the rehabilitation process. Subjective needs for social relations are measured and compared with adjustm...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1983-02-01 00:00:00
abstract:OBJECTIVES:To evaluate changes in sleep quality and objectively assessed sleep parameters after traumatic brain injury (TBI) and to investigate the relationship between such changes and mood state and injury characteristics. DESIGN:Survey and laboratory-based nocturnal polysomnography. SETTING:Sleep laboratory. PART...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2007.09.057
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:To determine whether the International Classification of Functioning, Disability and Health (ICF) categories relevant to spinal cord injury (SCI) can be integrated in clinical measures and to obtain insights to guide their future operationalization. Specific aims are to find out whether the ICF categories re...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1016/j.apmr.2014.05.006
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To assess the short-term outcome of a back school program for patients suffering from chronic, nonspecific low back pain (LBP). DESIGN:Quasi-experimental cohort study with a waiting list control group. SETTING:Dutch rehabilitation department. PARTICIPANTS:Experimental group (n = 14) participating in the ba...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1053/apmr.2001.23899
更新日期:2001-08-01 00:00:00
abstract::The health care delivery system in the United States is challenged to meet the needs of a growing population of cancer survivors. A pressing need is to optimize overall function and reduce disability in these individuals. Functional impairments and disability affect most patients during and after disease treatment. Re...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2016.05.002
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:To establish self-efficacy and depressive mood trajectories in adults with spinal cord injury (SCI), determine their interrelationship over time, and determine the influence that appraisals and comorbid physical conditions have on the development of self-efficacy. DESIGN:A prospective cohort design. SETTIN...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2018.07.442
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To examine the agreement of scores between the Disabilities of the Arm, Shoulder and Hand (DASH) and QuickDASH questionnaires in patients with distal radius fractures (DRFs) and their score's concurrent validity with Patient-Rated Wrist Evaluation (PRWE) scores. DESIGN:Validity study. SETTING:Hand and upper...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2016.11.023
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To assess the effects of an 8-week aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS). DESIGN:Randomized controlled design. SETTING:Referral center of an MS society. PARTICIPANTS:Women (N=32; mean age ± SD, 36.4±8.2y) with dia...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.apmr.2017.06.015
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the success of fluoroscopically guided, contrast-enhanced lumbar zygapophyseal joint (Z-joint) aspiration and steroid injection combined with transforaminal epidural steroid injections (TFESIs) for the treatment of lumbar Z-joint cyst-induced radicular pain. DESIGN:Retrospective case series with ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2004.11.051
更新日期:2005-09-01 00:00:00
abstract:UNLABELLED:Liang C-C, Hsieh T-C, Lin C-H, Wei Y-C, Hsiao J, Chen J-C. Effectiveness of thermal stimulation for the moderately to severely paretic leg after stroke: serial changes at one-year follow-up. OBJECTIVE:To evaluate the serial changes of long-term effects of thermal stimulation (TS) on acute stroke patients. ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.apmr.2012.06.016
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:To compare the measurement properties and responsiveness to change of the Patient Health Questionnaire-9 (PHQ-9), the Hopkins Symptom Checklist-20 (HSCL-20), and the Hamilton Depression Rating Scale (HAM-D) in people with spinal cord injury (SCI) diagnosed with major depressive disorder (MDD). DESIGN:Second...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.apmr.2016.01.017
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To determine the validity of the 6-minute walk test (6MWT) as an outcome measure to evaluate walking capacity in ambulatory patients with amyotrophic lateral sclerosis (ALS). DESIGN:Observational study. SETTING:Multidisciplinary ALS clinic at an academic medical center. PARTICIPANTS:Patients with ALS (N=18...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2017.04.004
更新日期:2017-11-01 00:00:00
abstract::The H-reflex has been recorded from the flexor carpi radialis muscle in the upper limb and vastus medialis (quadriceps) muscle in the lower limb in relaxed healthy subjects. The characteristics of these reflexes have been compared with those of the soleus H-reflexes, recorded with the same technique, and similar behav...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::Traditional approaches to psychological assessment of chronic pain patients have centered either on underlying psychopathology or environmental reinforcers for pain behavior. The current research focuses on patient beliefs and attitudes about their pain and its treatment, an additional dimension which appears to be im...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::Prevention of pressure sores is a major objective in the rehabilitation of individuals with paraplegia and quadriplegia. Wheelchair cushions made of polyurethane foam are frequently prescribed to relieve pressure and reduce the risk of ulceration for persons seated in wheelchairs. Because no cushion uniformly distribu...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract::Although somatosensory loss following stroke is common, with negative consequences for functional outcome, studies of existing somatosensory retraining programs are limited by theoretical weaknesses, poor methodology, and negative findings. We, therefore, developed a new program for stroke patients and investigated it...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/0003-9993(93)90158-7
更新日期:1993-06-01 00:00:00
abstract::The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on the provision of medical care. As the curve progresses and patients are discharged, the rehabilitation wave brings a high number of postacute COVID-19 patients suffering from physical, mental, and cognitive impairments threatening their re...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2020.09.372
更新日期:2020-12-01 00:00:00
abstract::The accomplishments of 50 years in matters of federal legislation and programs affecting PM&R were made possible in large part through the dedication of specialists in PM&R who, first and foremost, were advocates of measures which would serve best the interests of the nation's handicapped and disabled. The contributio...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 历史文章,杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:To resolve the debate over whether lumbar repositioning acuity is reduced in patients with chronic low back pain (CLBP) by using a study design and methodology to minimize the effects of potential confounders. DESIGN:A single-blinded, controlled, multigroup comparative study. SETTING:Vocational rehabilitati...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2006.05.020
更新日期:2006-09-01 00:00:00
abstract::Muscle enlargement and hypertrophy are rare findings in neurogenic lesions. The two in combination have been reported in cases of peripheral nerve lesions, polyneuropathy, and poliomyelitis. True and pseudo muscle hypertrophy are the two possible etiologies, whereas infiltration, stretch, or exercise of the muscle are...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To assess the relationship between delays in initiation and termination of tibialis anterior contraction in the hemiplegic lower limb and clinical measures of lower-limb motor impairment and mobility. DESIGN:Cross-sectional correlational study. SETTING:Outpatient rehabilitation clinic of an academic medical...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2006.05.007
更新日期:2006-09-01 00:00:00