The incidence rate, location, and timing of falls and performance of activities of daily living (ADLs) in 256 patients with stroke admitted to an 88-bed rehabilitation ward was observed with information on falls and level of ADLs upon admission extracted from patients' records. Of 273 falls among 121 of the 256 patients, 229 occurred in the patient's room or lavatory and 147 within 4 weeks of admission. Significant differences were detected between motor subscores under 64 and over 65 on the Functional Independence Measure (FIM) in fall proportional analysis. The mean fall rate in motor subclass of 26 to 38 was higher than in other subgroups. Those with cognitive subscore on the FIM lower than 29 were prone to fall. Also, deteriorated motor and cognitive functions were associated with a high risk of falls.

No abstract

To clarify the importance of imaging plane in evaluation of invasion by tumor into muscle, 50 patients with bladder tumors underwent examination with magnetic resonance (MR) imaging performed with an oblique plane and the early phase of contrast enhancement. After the ideal oblique plane was selected, an oblique T2-weighted image was obtained. Gadopentetate dimeglumine was then administered, and an oblique T1-weighted image was obtained. The staging based on oblique T2-weighted and oblique contrast material-enhanced T1-weighted MR images was then correlated with histopathologic staging. The respective accuracies of oblique contrast-enhanced T1-weighted and oblique T2-weighted images were 78% and 60% for overall staging (P < .05), 90% and 74% for differentiation between (a) stage T1 and lower-stage tumors and (b) stage T2 and higher-stage tumors (P < .05), and 92% and 88% for differentiation between (a) stage T2 and lower-stage tumors and (b) stage T3a and higher-stage tumors (P > .05). Oblique MR imaging performed in conjunction with the early phase of contrast enhancement showed significantly high staging accuracy, especially in differentiation between superficial tumors and tumors with superficial muscle invasion.

4are widely used as classifications of ischemic stroke subtype. Although the pathologies of these subtypes are described by these criteria, no diagnostic methods or standards exist for neuroimaging and other examinations. The current diagnostic standards for ischemic stroke subtype used in clinical trials are from the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classifications.5 According to the TOAST classification system, artery-to-artery embolism (A-to-A) can be distinguished from atherothrombosis, 6 and both can be distinguished from CE. However, these concepts are not well Background and Purpose-We investigated the factors influencing inpatient convalescent rehabilitation outcomes in patients with ischemic stroke, particularly severity of leukoaraiosis on magnetic resonance imaging. Methods-Participants included 520 patients with ischemic stroke (317 men and 203 women; mean age, 72.8±8.4 years) who were transferred from acute care hospitals for inpatient convalescent rehabilitation. Ischemic stroke subtypes included lacunar infarction (n=41), atherothrombosis (n=223), artery-to-artery embolism (n=67), cardiogenic embolism (n=97), undetermined embolism (n=76), and uncategorized ischemic stroke (n=16). Leukoaraiosis was graded according to periventricular hyperintensity (PVH) and deep white matter hyperintensity on magnetic resonance imaging. Functional Independence Measure scores were assessed on admission and at discharge. Results-Multiple regression analysis revealed that rehabilitation outcomes, measured as total Functional IndependenceMeasure scores, were significantly associated with leukoaraiosis estimated by PVH grade. This association was observed after adjustment for factors such as severity, age, and poststroke history. In all patients, PVH grades were associated with Functional Independence Measure motor scores (P<0.001), whereas in patients with artery-to-artery embolism or cardiogenic embolism and deep white matter hyperintensity grades were associated with Functional Independence Measure cognitive scores (P<0.05). Conclusions-Our study revealed that the degree of leukoaraiosis was associated with inpatient convalescent rehabilitation outcome in patients with ischemic stroke. Furthermore, the PVH grade was associated with motor function outcome, whereas the deep white matter hyperintensity grade correlated with cognitive function outcome, likely because the progression patterns and anatomic backgrounds of PVH and deep white matter hyperintensity differ according to ischemic stroke subtype.