R Tabatabaei | PubMed Health

PubMed2001

Comparing stroke rehabilitation outcomes between acute inpatient and nonintense home settings.

OBJECTIVE: To compare outcomes in stroke survivors who received rehabilitation services in an acute inpatient rehabilitation setting (multidisciplinary rehabilitation team) with outcomes in survivors in a home-based setting (family caregivers, limited team supervision). DESIGN: Randomized clinical trial, with mean follow-up after 60 days. SETTING: Inpatient rehabilitation setting and home-based settings. PATIENTS: Sixty patients (age range, 43-80yr) who had a stroke between 1996 and 1999 and had been referred after medical stabilization, randomly divided into 2 groups: group 1, inpatient rehabilitation; group 2, home-based rehabilitation. INTERVENTIONS: Group 1: therapeutical and neuromuscular exercises with occupational therapy with professional supervision; group 2: conventional exercises with family caregiver and limited professional supervision. MAIN OUTCOME MEASURES: Spasticity was evaluated with the Ashworth Scale, motor status with Brunnstrom's stages, functional status with the FIM instrument, and cognitive status with the Mini-Mental State Examination before and after rehabilitation. RESULTS: Patients rehabilitated in acute inpatient settings had better motor, functional, and cognitive outcomes (p < .05). Spasticity changes did not differ between the groups. CONCLUSION: Intense inpatient rehabilitation services for stroke survivors provide significantly more favorable functional and cognitive outcomes with relatively low complications than did nonintense rehabilitation efforts in home settings.

Adult↗

PubMed2001

Cognitive evaluation and functional outcome after stroke.

OBJECTIVE: To investigate the initial overall cognitive ability and its components as a predictor of functional improvement and ambulation during rehabilitation. Initial cognitive status is widely known to be a predictive factor in functional recovery in patients with stroke although some reports have found no such relationship. DESIGN: Baseline cognitive status was scored by Minimental State Examination and its subsections with such headings as "orientation," "registration," "attention and calculation," "recall," and "language" in 43 patients with postacute stroke, aged between 51 and 68 yr. Function was evaluated in terms of motor FIM and functional ambulation as categorized in "Adapted Patient Evaluation and Conference System" functional scale at the time of admission and discharge. RESULTS: Only total baseline Minimental State Examination score showed a significant correlation with discharge motor FIM improvement (r = 0.31, P = 0.04) and baseline orientation score correlated significantly with functional ambulation score improvement (r = 0.31, P = 0.03). In stepwise linear regression model, the same variables had an effect on similar outcome parameters. CONCLUSIONS: Cognitiveion evaluation should be taken as a whole to predict functional outcome in patients with postacute stroke, except for the baseline orientation score that seemed more predictive for ambulation.

Activities of Daily Living↗