Functional recoveries of patients with branch atheromatous disease after rehabilitation: Comparison with other types of cerebral infarction and importance of stratification by clinical categories

Abstract

Background: Functional recoveries after rehabilitation of patients with branch atheromatous disease (BAD) have not been well investigated, however, clinical category of cerebral infarction including BAD itself could be a potential predictive factor for functional outcome. Objective: To describe characteristics of functional recoveries of patients with BAD through comparison with other types of cerebral infarction. Methods: We retrospectively compared outcomes of patients with BAD (N = 222), cardioembolic cerebral infarction (CE: N = 177) and atherothrombotic cerebral infarction (AT: N = 219) by using functional independence measure (FIM) and FIM effectiveness (the proportion of potential for improvement achieved). Results: Univariate analysis showed that FIM on discharge was comparable among three types of cerebral infarction, but that FIM effectiveness in patients with BAD was significantly higher than those with CE or AT. Stratified analysis revealed higher FIM effectiveness in patients with BAD compared to patients with CE or AT, if they were male, younger (≤72 years) or had supratentorial brain lesions. Multiple regression analysis demonstrated that location of the brain lesion (supratentorial vs infratentorial) and gender (male vs female) were significantly associated with FIM on discharge, and that cognitive function on admission as well as gender were significantly associated with FIM effectiveness in patients with BAD, but not in patients with CE or AT. Conclusions: Outcomes after rehabilitation of patients with BAD may be characterized by better functional improvement, especially if patients are male, relatively younger or with supratentorial lesions. The impact and the type of factors related to functional recoveries of patients with BAD may be different from other types of stroke. The present study suggested that clinical category of stroke should be taken into consideration in prediction of outcomes and planning of rehabilitation management.

Effects of All-Inclusive and Hierarchical Rehabilitation Nursing Model Combined with Acupuncture on Limb Function and Quality of Life in Elderly Patients with Cerebral Infarction during Convalescence

“…The patients' daily life is severely impacted. According to the study of Okuda et al, the limb dysfunction and failure of independent living enhance the negative emotions of the elderly patients with cerebral infarction and significantly decrease their living wills [ 9 ]. Therefore, it is extremely important to improve the patients' physical function and quality of life.…”

Branch atheromatous disease and treatment

“…[ 26 27 ] Male gender, young age, and supratentorial lesions are associated with better functional improvement. [ 28 ]…”