Biomedical subjects

S Levenkrohn

Publications and source records attributed to S Levenkrohn.

6 recordsLinked to original sources

PubMed2002

A comparative study of Mini-Mental Test, Clock Drawing task and Cognitive-FIM in evaluating functional outcome of elderly hip fracture patients.

OBJECTIVE: To compare the clock drawing task with other cognitive tests used for the prediction of discharge functional outcome, in elderly hip fracture patients. DESIGN: Cohort study. SETTING: A department of geriatric-orthopaedic rehabilitation of a tertiary hospital. PATIENTS: One hundred and forty-three consecutive patients undergoing inpatient comprehensive rehabilitation following hip fracture. MEASUREMENTS: Cognitive status was assessed by the Clock Drawing Task, Mini-Mental State Examination (MMSE) and the Cognitive-FIM (cognFIM). Functional status outcome was evaluated by the Functional Independence Measure (FIM), using absolute and relative parameters of efficacy and efficiency. RESULTS: Correlation coefficients (Pearson correlation) between the three cognitive tests resulted in values ranging from 0.607 to 0.732 (p < 0.001). Similar correlation coefficients were observed for all cognitive tests when correlated with relative efficacy and efficiency outcome parameters (p < 0.001), but not with absolute outcome parameters. CONCLUSIONS: Clock Drawing Test is similar to Mini-Mental and Cognitive-FIM with respect to the evaluation of functional status outcome following rehabilitation of hip fractures. The similar correlations with functional outcome parameters as well as the simplicity of administration favour the use of either Clock Drawing Task or MMSE in the initial assessment of elderly patients with hip fractures.

Aged↗

PubMed1999

[Sacral insufficiency fractures and low back pain in elderly women].

Sudden low back pain is common in elderly women. It causes physical and mental stress, and results in deterioration of functional movement and in activities of daily living. Awareness of possible sacral insufficiency fracture is important; they may be demonstrated by imaging modalities, mainly radionuclide bone scan. Prognosis is good and accurate diagnosis serves to exclude malignancy and relieve fear of chronic pain and disability. We describe 4 women, aged 84, 82, 71 and 77 who illustrating the clinical and imaging findings of this disorder.

Aged↗

PubMed1998

[Evaluation of predictive factors for stroke rehabilitation].

Our objective was to assess the functional disability of stroke patients by the functional independence measure (FIM) and to examine predictive factors for successful rehabilitation. In 127 consecutive stroke patients efficacy of FIM was 23.9 +/- 188, efficiency 0.54 +/- 0.45, and 81.9% of patients returned home. Functional improvement was statistically significant (p < 0.001) in all FIM domains. Multivariate analysis showed that improvement in FIM score was significantly greater in the younger, among the married, the hemiparetic, and those with an admission FIM of 40-60, while efficiency was related only to type of diagnosis. In addition, the hemiparetic were 3.3 times more likely to return home than the hemiplegic. We conclude that rehabilitation priorities should be directed towards patients younger than 75 years and to those with an admission FIM of 40-60 points. The results of this study reaffirm the usefulness of the FIM index in assessing stroke rehabilitation.

Activities of Daily Living↗

PubMed1997

[Central cord syndrome in the elderly who fall: a diagnostic trap].

Acute post-traumatic spinal injury is common and usually poses no diagnostic difficulties. Following a low-energy fall, the onset of acute central cord syndrome in the elderly is not common and is frequently misdiagnosed. Men aged 60 and 81, and a woman aged 75 are described, in whom central cord syndrome was overlooked. Awareness of this condition is important to avoid incorrect diagnosis and hazardous management.

Accidental Falls↗

PubMedDate not supplied

Rehabilitation outcomes in patients with full weight-bearing hip fractures.

Evaluation of the functional outcome for hip fractured elderly patients has been controversial due to a typical casemix containing both weight bearing and non weight bearing postoperative fractures. The purpose of this study was to investigate factors associated with rehabilitation outcomes in patients who are able to fully weight bearing following surgical repair of femoral neck fracture. We studied 217 consecutive patients admitted for rehabilitation after surgery for hip fracture. Age, gender, marital status, type of fracture and admission Functional Independence Measure (FIM) were evaluated as possible predictors of rehabilitation outcome. Functional gains were evaluated according to FIM. Dependent outcome variables were calculated as absolute (total FIM gain and daily FIM gain) as well as relative (to potential). Results showed a significant improvement in absolute total and daily FIM gains (19.32+/-8.29, and 0.87+/-0.44, respectively). Relative total functional gain was 0.40+/-0.19. Absolute total functional gain did not depend on FIM admission, whereas all other parameters were significantly correlated with FIM scores on admission, indicating a relatively adverse rehabilitation in patients with an admission FIM of 40 points or lower. The majority (83.9%) of patients were discharged home. A significant association exists between the ability to go home and marital status (P=0.009), as well as with admission FIM (P<0.0001). We conclude that encouraging outcome results are achieved in the elderly with full weight bearing fractures. The absolute functional gains do not depend on FIM admission scores and argues for inclusion of patients with low admission FIM scores to rehabilitation programs. However, the relative gains are significantly better in patients with higher admission FIM scores, thus supporting inclusion of selected patients. This poses serious ethical issues for healthcare policy-makers.

Journal Article↗

PubMedDate not supplied

Clock drawing task, mini-mental state examination and cognitive-functional independence measure: relation to functional outcome of stroke patients.

The use of reliable and valid brief cognitive screening instrument for selecting the appropriate candidates for stroke rehabilitation is crucial. Clinicians often face the question which test should be preferred, that will best correlate with functional outcome. The objective of this study was to compare the clock drawing task with other cognitive tests used for the evaluation of discharge functional outcome in elderly stroke patients. We conducted a retrospective chart study including 151 consecutive patients, admitted for inpatient comprehensive rehabilitation following acute stroke. The clock drawing task (CDT), mini-mental state examination (MMSE) and the cognitive-functional independence measure (cognFIM) were used to assess the cognitive status. Functional status outcome was evaluated by the functional independence measure (FIM), using absolute and relative parameters of efficacy and efficiency. Correlation coefficients (Pearson correlation) between the three cognitive tests resulted in r-values ranging from 0.51 to 0.59 (P<0.001). All three tests correlated significantly with motor outcomes. MMSE did not confer additive value to CDT. It is concluded that CDT is similar to mini-mental and both are somewhat better than cognFIM with respect to the evaluation of functional status outcome following stroke. The correlations between the tests as well as the simplicity of administration favor the use of either CDT or MMSE in the initial assessment of elderly stroke patients.

Journal Article↗