Long-term outcome of severe stroke patients: Is the ADL status at discharge from a stroke center indicative of the long-term outcome?

Abstract

The objective of this study was to examine the possibility of predicting the long-term outcome of severe stroke patients from the ADL status at discharge. The design is a retrospective observational study in the stroke center at Tokushima University Hospital. Severe stroke patients at discharge with Barthel Index (BI) scores ≤ 40 (N=51) were divided into two subgroups retrospectively, improved and unimproved. The Functional Independence Measure (FIM) and BI were analyzed at discharge, 3 and 6 months after onset. Correlation analysis between BI and FIM showed good correlation, especially between BI and motor FIM (mFIM). In conclusion, the ADL status at discharge from a stroke center is not definitely indicative of the long-term outcome, although good recovery of severe stroke cases was observed in males and younger patients, and in patients with motor FIM score>25. This result shows that the first 3 months after the attack should be regarded as an important time window for intensive rehabilitation.

Differences in Obesity Rates Between People With and Without Disabilities and the Association of Disability and Obesity: A Nationwide Population Study in South Korea

“…It was found that even in the case of those with the same disability type, the influence on obesity rate varies, depending on the extent of restrictions on physical and dietary activities as well as differences in energy metabolism in accordance with grade of disability. In the case of people with severe disabilities, they tend to exert more energy during physical activities due to activity impairment caused by combinations of problems in vision, hearing, and static sense, and have difficulties in eating due to lowered cognitive function and a weakened state of consciousness [22-24]. In other words, people with severe disability show low obesity rates because of decreased calorie intake due to restrictions on physical activities and increased consumption of energy during physical activities.…”

Foot Placement and Arm Position Affect the Five Times Sit-to-Stand Test Time of Individuals with Chronic Stroke

“…Stroke is a common cause of impaired mobility and disability in daily activity [1–3]. Rehabilitation after stroke usually is a prolonged or even lifelong undertaking for the survivors [4].…”

Is the Recovery of Functional Balance and Mobility Accompanied by Physiological Recovery in People With Severe Impairments After Stroke?

“…Many inpatient rehabilitation hospitals have raised their admission FIM requirements, such that people with severe impairments have limited access to dedicated stroke care units and remain on general recovery units where therapy intensity remains low, 6 despite evidence that improvements on the motor FIM are possible months later. 7,8…”

“…Many inpatient rehabilitation hospitals have raised their admission FIM requirements, such that people with severe impairments have limited access to dedicated stroke care units and remain on general recovery units where therapy intensity remains low, 6 despite evidence that improvements on the motor FIM are possible months later. 7,8 Very little is known about the capacity for physiological recovery in people with severe impairments after stroke. Many studies exclude people with severe stroke; for example, brain imaging research often excludes people who have sustained a severe stroke, though when severe stroke patients are imaged, physiological improvements can be demonstrated.…”