- Email: [email protected]
Factors necessary for independent walking in patients with putaminal hemorrhage
Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
Conclusion The cortical mechanism leading to the positive effect of sensory cueing might be contributed by the enhanced attention and activation of the prefrontal cortex for preparedness of movements. Keywords Stroke; Upper extremity; Hemodynamics Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.451 ISPR8-0922
Factors necessary for independent walking in patients with putaminal hemorrhage
S. Maeshima ∗ , S. Okamoto , H. Okazaki , H. Maeda , I. Fuse , H. Hori , K. Yagihashi , Y. Senju , A. Kiso , S. Sonoda Fujita Health University, School of Medicine, Tsu, Japan ∗ Corresponding author. E-mail address: [email protected] (S. Maeshima) Introduction/Background Putaminal haemorrhage accounts for 30%–40% of all cerebral haemorrhages and is responsible for various neurological symptoms, including motor paralysis. Its prognosis varies according to factors such as age, neurological severity, site and size of hematoma, complications, and choice of treatment. We examined the factors related to independent walking in patients with putaminal hemorrhage who were admitted to a rehabilitation hospital. Material and method We evaluated 264 patients with thalamic hemorrhage (172 men and 92 women; age range, 29–88 years) who were admitted to our rehabilitation hospital. The mean duration from symptom onset to rehabilitation hospital admission was 29.9 ± 14.8 days, and the mean rehabilitation hospital stay was 74.6 ± 35.3 days. Patients’ neurological and cognitive functions were examined with the National Institutes of Health Stroke Scale (NIHSS) and Mini-Mental State Examination (MMSE), respectively. The relationship between patients’ scores on these scales and their walking ability at discharge from the rehabilitation hospital was analyzed. Additionally, a decision-tree analysis was used to create a model for predicting independent walking upon referral to the rehabilitation hospital. Results Among the patients, 143 could walk independently and 121 could not. The two patient groups were significantly different in terms of age, duration from symptom onset to rehabilitation hospital admission, hematoma type, hematoma volume, neurological symptoms, and cognitive function. The decision-tree analysis revealed that the patient’s age, motor leg of the NIHSS, MMSE score, and hematoma volume were factors that could predict independent walking. Conclusion In patients with putaminal hemorrhage, the neurological symptoms, and neuroimaging factors at onset are useful for predicting independent walking. Keywords Cerebral hemorrhage; Ambulation; Functional outcome Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.452
e197
ISPR8-0506
Effect of comorbidity on functional recovery in stroke patients M. Kao 1,∗ , K.C. Chiu 2 , P.H. Lin 2 , S.Y. Lin 2 Taipei City Hospital, Zhong Xiao Branch, Rehabilitation, Taipei City, Taiwan, ROC 2 Taipei City Hospital, Yang Ming Branch, Rehabilitation, Taipei City, Taiwan, ROC ∗ Corresponding author. E-mail address: [email protected] (M. Kao)
1
Introduction/Background The impact of comorbidities on stroke functional recovery has yet to be studied in Taiwan. This study evaluated the comorbidities and their impact on functional recovery in stroke patients. Material and method The participants were 105 acute stroke patients with moderate to severe functional disability who were admitted for comprehensive rehabilitation. Participants were 76 people who underwent Post-acute Care program and other 29 participants accepted a regular rehabilitation program within six months after stroke. The effect of each comorbidity on the patients’ post-hospitalization daily living activities was analyzed based on the Charlson Comorbidity Index (CCI). Results The average Barthel Index (BI) scores increased from 41.8 at admission to 75.5 at discharge; the average progress was 33.7 points. The stroke patients in control group had an average BI score of 37.2 at admission and 47.2 at discharge; the average progress was only 10 points. The functional recovery rate of daily living activities in the post-acute care group was equal to [(BI scoring improvement/BI at admission) × 100%] and was significantly higher than that of the control group (post-acute care: control = 1.4 ± 1.7/0.4 ± 0.6; P = 0.015). For each 1 point increase to a patient’s CCI score, there was a 0.97 point decrease to the patient’s score on the BI after discharge from the hospital (P = 0.013). An analysis of 19 comorbidities showed that the order of highest prevalence was diabetes (21%), prior cerebrovascular accident with mild or no residual or transient ischemic attack (17.1%), and diabetes with end-organ damage (14.3%). Analysis of the impact of the various comorbidities on stroke patients’ daily living activities indicated that the most harmful disease was chronic pulmonary disease, followed by prior history of hemiplegia. Conclusion Comorbidities, especially chronic pulmonary disease and hemiplegia, can affect the functional recovery and daily living activities of stroke patients. Keywords Stroke; Outcome; Comorbidity Disclosure of interest The authors declare that they have no competing interest. Appendix A Supplementary data Supplementary data associated with this article can be found, in the online version, at https://doi.org/10.1016/j.rehab.2018.05.453. https://doi.org/10.1016/j.rehab.2018.05.453 ISPR8-1136
Short-term effect of low intensity forced aerob exercise added to conventional physiotherapy on cognitive functions and fitness after stroke: A randomized controlled pilot study
Z. Jenei ∗ , A. Nagy , N. Kovacs , J. Horvath University of Debrecen Faculty of Medicine, Physical Medicine and Rehabilitation, Debrecen, Hungary ∗ Corresponding author. E-mail address: [email protected] (Z. Jenei) Introduction/Background Emerging experimental and clinical findings suggest that aerob forced exercise may potentially have
Conclusion The cortical mechanism leading to the positive effect of sensory cueing might be contributed by the enhanced attention and activation of the prefrontal cortex for preparedness of movements. Keywords Stroke; Upper extremity; Hemodynamics Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.451 ISPR8-0922
Factors necessary for independent walking in patients with putaminal hemorrhage
S. Maeshima ∗ , S. Okamoto , H. Okazaki , H. Maeda , I. Fuse , H. Hori , K. Yagihashi , Y. Senju , A. Kiso , S. Sonoda Fujita Health University, School of Medicine, Tsu, Japan ∗ Corresponding author. E-mail address: [email protected] (S. Maeshima) Introduction/Background Putaminal haemorrhage accounts for 30%–40% of all cerebral haemorrhages and is responsible for various neurological symptoms, including motor paralysis. Its prognosis varies according to factors such as age, neurological severity, site and size of hematoma, complications, and choice of treatment. We examined the factors related to independent walking in patients with putaminal hemorrhage who were admitted to a rehabilitation hospital. Material and method We evaluated 264 patients with thalamic hemorrhage (172 men and 92 women; age range, 29–88 years) who were admitted to our rehabilitation hospital. The mean duration from symptom onset to rehabilitation hospital admission was 29.9 ± 14.8 days, and the mean rehabilitation hospital stay was 74.6 ± 35.3 days. Patients’ neurological and cognitive functions were examined with the National Institutes of Health Stroke Scale (NIHSS) and Mini-Mental State Examination (MMSE), respectively. The relationship between patients’ scores on these scales and their walking ability at discharge from the rehabilitation hospital was analyzed. Additionally, a decision-tree analysis was used to create a model for predicting independent walking upon referral to the rehabilitation hospital. Results Among the patients, 143 could walk independently and 121 could not. The two patient groups were significantly different in terms of age, duration from symptom onset to rehabilitation hospital admission, hematoma type, hematoma volume, neurological symptoms, and cognitive function. The decision-tree analysis revealed that the patient’s age, motor leg of the NIHSS, MMSE score, and hematoma volume were factors that could predict independent walking. Conclusion In patients with putaminal hemorrhage, the neurological symptoms, and neuroimaging factors at onset are useful for predicting independent walking. Keywords Cerebral hemorrhage; Ambulation; Functional outcome Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.452
e197
ISPR8-0506
Effect of comorbidity on functional recovery in stroke patients M. Kao 1,∗ , K.C. Chiu 2 , P.H. Lin 2 , S.Y. Lin 2 Taipei City Hospital, Zhong Xiao Branch, Rehabilitation, Taipei City, Taiwan, ROC 2 Taipei City Hospital, Yang Ming Branch, Rehabilitation, Taipei City, Taiwan, ROC ∗ Corresponding author. E-mail address: [email protected] (M. Kao)
1
Introduction/Background The impact of comorbidities on stroke functional recovery has yet to be studied in Taiwan. This study evaluated the comorbidities and their impact on functional recovery in stroke patients. Material and method The participants were 105 acute stroke patients with moderate to severe functional disability who were admitted for comprehensive rehabilitation. Participants were 76 people who underwent Post-acute Care program and other 29 participants accepted a regular rehabilitation program within six months after stroke. The effect of each comorbidity on the patients’ post-hospitalization daily living activities was analyzed based on the Charlson Comorbidity Index (CCI). Results The average Barthel Index (BI) scores increased from 41.8 at admission to 75.5 at discharge; the average progress was 33.7 points. The stroke patients in control group had an average BI score of 37.2 at admission and 47.2 at discharge; the average progress was only 10 points. The functional recovery rate of daily living activities in the post-acute care group was equal to [(BI scoring improvement/BI at admission) × 100%] and was significantly higher than that of the control group (post-acute care: control = 1.4 ± 1.7/0.4 ± 0.6; P = 0.015). For each 1 point increase to a patient’s CCI score, there was a 0.97 point decrease to the patient’s score on the BI after discharge from the hospital (P = 0.013). An analysis of 19 comorbidities showed that the order of highest prevalence was diabetes (21%), prior cerebrovascular accident with mild or no residual or transient ischemic attack (17.1%), and diabetes with end-organ damage (14.3%). Analysis of the impact of the various comorbidities on stroke patients’ daily living activities indicated that the most harmful disease was chronic pulmonary disease, followed by prior history of hemiplegia. Conclusion Comorbidities, especially chronic pulmonary disease and hemiplegia, can affect the functional recovery and daily living activities of stroke patients. Keywords Stroke; Outcome; Comorbidity Disclosure of interest The authors declare that they have no competing interest. Appendix A Supplementary data Supplementary data associated with this article can be found, in the online version, at https://doi.org/10.1016/j.rehab.2018.05.453. https://doi.org/10.1016/j.rehab.2018.05.453 ISPR8-1136
Short-term effect of low intensity forced aerob exercise added to conventional physiotherapy on cognitive functions and fitness after stroke: A randomized controlled pilot study
Z. Jenei ∗ , A. Nagy , N. Kovacs , J. Horvath University of Debrecen Faculty of Medicine, Physical Medicine and Rehabilitation, Debrecen, Hungary ∗ Corresponding author. E-mail address: [email protected] (Z. Jenei) Introduction/Background Emerging experimental and clinical findings suggest that aerob forced exercise may potentially have