Biomedical subjects

Stephen Bagg

Publications and source records attributed to Stephen Bagg.

3 recordsLinked to original sources

PubMed2006

Functional status and health-related quality of life during inpatient stroke rehabilitation.

OBJECTIVE: To examine changes in functional status and health-related quality of life (HRQOL) during inpatient stroke rehabilitation to examine the associations between changes in the two measures. DESIGN: Two independently collected databases were combined for a retrospective analysis. One contained the objectively assessed FIM score; the other contained the subjectively assessed Medical Outcomes Study 36-item short form (SF-36). Admission and discharge scores were compared using paired-samples t tests. Associations between the FIM outcomes and the SF-36 outcomes were assessed by means of Pearson's product-moment correlations. RESULTS: One hundred sixteen patients were represented in both databases. Mean age was 71.4 yrs; 59 (51.1%) were female. All FIM scores, four of eight SF-36 domains, and one summary component score showed statistically significant improvement during the course of rehabilitation. Changes in SF-36 were not strongly associated with changes in FIM score, with only 6 of 90 correlations attaining statistical significance. CONCLUSIONS: Functional status and HRQOL improved considerably over the course of rehabilitation. However, there was poor association between the two outcomes. Both instruments offer insights into outcomes of inpatient rehabilitation, but they are complementary rather than overlapping.

Activities of Daily Living↗

PubMed2006

Evidence-based practice and setting basic standards for stroke rehabilitation in Canada.

It is a concern that the consistency of care in stroke rehabilitation appears to vary significantly among practice settings within Canada. Based upon an evidence-based review of stroke rehabilitation, a group of physiatrists from across Canada agreed to some basic standards for stroke rehabilitation. The following standards were deemed to be critical to providing effective stroke rehabilitation care: early assessment and quick access to specialized interdisciplinary rehabilitation, appropriate intensity of therapies, availability of outpatient therapy, appropriate community supports, and careful attention to secondary prevention of stroke. Providing stroke rehabilitation care consistently within these standards remains a challenge, particularly given the potential initial costs, despite significant improvements in patient outcomes and quality of life. Nevertheless, these standards should be the expectation of stroke patients, essentially forming a stroke rehabilitation "bill of rights."

Canada↗

PubMed2002

Effect of age on functional outcomes after stroke rehabilitation.

BACKGROUND AND PURPOSE: The incidence of stroke and the demand for stroke rehabilitation services continues to increase, and it has been proposed that age be used in combination with severity of stroke to determine type of rehabilitation. It is important to identify the impact of age on functional outcome before embracing a system that limits access to rehabilitation on the basis of age. METHODS: This prospective study includes all patients admitted to an inpatient stroke rehabilitation program for 6 years. Demographic and clinical data were extracted by means of chart review. Functional status at admission and discharge was evaluated by means of the FIM instrument. Multivariate regression techniques were used to assess the relationships between age, functional outcome, and other predictive variables. Particular attention was paid to the r(2) values to assess the amount of variation accounted for by the predictors. RESULTS: Age alone was a significant predictor of total FIM score and Motor FIM score at discharge, but not FIM change. For both total FIM score and Motor FIM score at discharge, age alone accounted for only 3% of the variation in outcome. For all the models, age explained at the most 1.3% of the variation in functional outcome after adjustment for other factors, such as admission FIM score. CONCLUSIONS: The small amount of variation that can be explained by age alone and the questionable clinical relevance of such a small effect suggest that there is no justification to deny patients access to rehabilitation solely because of advanced age.

Adult↗