Investigation of inpatient convalescent rehabilitation outcomes in branch atheromatous disease (BAD)

譲, 千田; 慶一, 伊東; 健, 大山; 典孝, 米山; 一洋, 原; 亮一, 中村; 智子, 野田; 淳, 橋詰; 直樹, 熱田; 瑞規, 伊藤; 宏久, 渡辺; 敬三, 安井; 伴照, 小竹; 義久, 木田; 秀雄, 岸本; 元, 祖父江

doi:10.3995/jstroke.35.441

Jpn. J. Stroke

2013

DOI: 10.3995/jstroke.35.441

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Investigation of inpatient convalescent rehabilitation outcomes in branch atheromatous disease (BAD)

千田譲¹,

伊東慶一²,

大山健³

et al.

Abstract: 熱田直樹 1) 伊藤瑞規 1) 渡辺宏久 1) 安井敬三 3) 小竹伴照 2) 木田義久 2) 岸本秀雄 2) 祖父江元 1) 要旨：【目的】回復期入院リハビリテーション (リハビリ) での脳梗塞 branch atheromatous disease (BAD) の治療成績を検討した．【対象と方法】レンズ核線条体動脈領域 (LSA-BAD) 90 例と傍正中橋動脈領域 (PPA-BAD) 21 例に対し，入院時・退院時の脳卒中重症度 (NIHSS) ，機能的自立度評価法 (FIM) ，上肢・手指・下肢各 Brunnstrom stage (BRS) を検討した．【結果】 LSA-BAD 群は PPA-BAD 群に比べ入退院時 NIHSS は有意に重症であり，手指・上肢の機能改善は不良であった (p<0.05) ．LSA-BAD 群は入院時上肢・手指 BRS の退院時 3 段階以上の回復は稀だったが，両群とも退院時 FIM は多くが 100 点以上であった．【結論】回復期リハビリでの BAD を分類し検討することで，皮質脊髄路障害部位の違いによる運動麻痺と機能的自立度評価の回… Show more

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

Okuda

Aoike

Matsuzaki

et al. 2021

RNN

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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.

show abstract

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

Okuda

Aoike

Matsuzaki

et al. 2021

RNN

View full text Add to dashboard Cite

show abstract

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Investigation of inpatient convalescent rehabilitation outcomes in branch atheromatous disease (BAD)

Cited by 1 publication

References 13 publications

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

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

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