- Email: [email protected]
Long-term functional outcomes of stroke patients
e216
Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
upper limb paralysis and moderate spasm, accompanied with nonfluent aphasia when came to our department; and complained that his recovery had been rather slow for about two years. In addition to the custom rehabilitation, we applied a peripheral plus central rTMS paradigm to him, which included 3 sessions of peripheral magnetic stimulation to his paralyzed right forearm, followed by a session of high frequency rTMS to the bilateral sensorimotor cortex region. The total magnetic stimulation therapy lasted about 30 min a day, and was applied 5 days/week for 4 weeks. Results After 4 weeks’ treatment, the patient’s Fulg–Meyer upper limb assessment (FMA) score was obviously improved (from 27 to 37 points), and the spasm was largely relieved in his right hand and arm. Conclusion Peripheral plus central rTMS might be an effective treatment for motor dysfunction of chronic stroke patients. Keywords Motor dysfunction; Magnetic stimulation; Upper limb rehabilitation Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.499 ISPR8-0014
Long-term functional outcomes of stroke patients
R. Suksathien ∗ , T. Sukpongthai Maharat Nakhon Ratchasima Hospital, Department of Rehabilitation Medicine, Nakhon Ratchasima, Thailand ∗ Corresponding author. E-mail address: [email protected] (R. Suksathien) Introduction/Background Predictors of functional outcomes of stroke patients are important for providing efficient post-stroke care according to the degree of impairment. The authors attempted to use the data that are routinely recorded in acute stroke care to determine long-term functional outcomes of stroke patients. Material and method This analytic study examined the longterm functional outcomes of stroke patients admitted to Maharat Nakhon Ratchasima Hospital with acute stroke between January 1 and December 31, 2015. We recorded patients’ characteristic data and functional level on admission using Barthel index (BI) score. Long-term functional outcomes were evaluated with BI score at least 6 months after stroke onset by telephone interview and medical records. The predictors of long-term functional outcomes were determined with stepwise multiple logistic regression analysis. Results Of the 907 patients, 191 (21%) died during acute stroke admission, 117 (13%) died after and 210 (23%) were lost to followup and could not be contacted. There were 5 variables significantly correlated with good functional outcomes after multiple logistic regression analysis. Subjects aged 55 or under, male, admission BI score 30–100, muscle power grade 0–1 and with consciousness problems had adjusted odds ratios of 12.56, 3.78, 3.33, 0.28 and 0.24, respectively. Four variables correlated with poor functional outcomes were impaired consciousness, age over 65, more than 3 comorbidities, and admission BI score of 0–30 had adjusted odds ratios of 4.83, 4.08, 2.39, and 1.89 respectively. Conclusion Long-term functional outcomes of stroke patients were associated with age, consciousness, gender, muscle power, admission BI score and number of comorbidities. Keywords Stroke; Predictors; Long-term functional outcomes Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.500
ISPR8-2571
Effects of physical therapies aiming directly or indirectly at the recovery of balance after stroke. A meta-analysis A. Hugues 1,2,∗ , J. Di-Marco 3 , P. Janiaud 4 , Y. Xue 5,6 , J. Zhu 7 , J. Pires 8 , H. Khademi 9 , L. Rubio 10 , P. Hernandez Bernal 11 , Y. Bahar 12 , H. Charvat 13 , P. Szulc 14 , C. Ciumas 15,16 , H. Won 17,18 , M. Cucherat 4 , I. Bonan 19 , F. Gueyffier 20 , G. Rode 1,2 1 Hospices Civils de Lyon, Centre de Recherche de Neurosciences de Lyon, Université de Lyon, Lyon, France 2 Service de Médecine Physique et de Réadaptation, Hôpital Henry Gabrielle, Unité Impact, Plate-forme « Mouvement et Handicap », Saint-Genis Laval, France 3 Assistance publique–Hôpitaux de Paris, Université Paris Descartes, Service de Médecine Physique et de Réadaptation, Paris, France 4 CNRS Lyon, Université de Lyon 1, UMR 5558, Lyon, France 5 Université de Lyon, Université Claude-Bernard Lyon 1, 69008 Lyon, France 6 Université Saint-Étienne, HESPER EA 7425, 42023 Saint-Étienne, France 7 Université Jiaotong de Shanghai, Pharmacologie, Shanghai, China 8 Medicine Faculty of Oporto University, Rovisco Pais Rehabilitation Centre, Tocha and Oporto, Portugal 9 World Heath Organisation, International Agency of Research on Cancer, Lyon, France 10 Centro Lescer, Rehabilitation, Madrid, Spain 11 Rehaklinik Zihlschlach, Neurologisches Rehabilitationszentrum, Zihlschlacht, Switzerland 12 Hitit University Erol Olcok Training and Research Hospital, Physical Medicine and Rehabilitation, Corum, Turkey 13 Center for Public Health Sciences, National Cancer, Division of Prevention, Tokyo, Japan 14 Inserm, University of Lyon, UMR 1033, Lyon, France 15 Inserm U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon, Université de Lyon, Institute of Epilepsies, Lyon, France 16 Centre Hospitalier Universitaire Vaudois, Translational and Integrative Group in Epilepsy Research TIGER, Department of Clinical Neurosciences, Lausanne, Switzerland 17 Université Grenoble Alpes, UMR 5316 Litt&Arts, Grenoble, France 18 KyungHee University, Séoul, Republic of Korea 19 CHU de Rennes, Service de médecine physique et de réadaptation, Rennes, France 20 Hospices Civils de Lyon, CNRS Lyon, Université de Lyon 1, Service Hospitalo-Universitaire de Pharmaco-Toxicologie, UMR 5558, Lyon, France ∗ Corresponding author. E-mail address: [email protected] (A. Hugues) Introduction/Background After stroke, standing balance is usually described as a predictor of functional recovery. Regarding literature, various type of physical therapy (PT) is used to improve balance. The aim of this meta-analysis is to evaluate the effects of PT directly focused on balance training (DFBT) and theses of PT indirectly focused on balance training (IFBT) on balance after stroke. Material and method Randomised controlled trials (RCT), without language restriction, until October 2015, assessing the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke, the posturographic parameters in static condition and measures of independence in activities of daily living were included. Two independent authors (AH and JDM) led this selection following the Cochrane recommendations (Hugues et al., 2017). Results One hundred and ninety-three parallel and crossover RCT from 9337 records were included, involving 8018 subjects [study sample: mean 41.5 (SD 49.7) subjects, age: pooled mean 61.7 (pooled SD 12.78) years]. A significant difference in favor of PT compared to no treatment was immediately found after the intervention for the BBS (DFBT: 7 studies, mean difference [MD] 1.38; 95% confidence interval [CI] [0.71; 2.05]. IFBT: 18 studies, MD 1.88;
Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
upper limb paralysis and moderate spasm, accompanied with nonfluent aphasia when came to our department; and complained that his recovery had been rather slow for about two years. In addition to the custom rehabilitation, we applied a peripheral plus central rTMS paradigm to him, which included 3 sessions of peripheral magnetic stimulation to his paralyzed right forearm, followed by a session of high frequency rTMS to the bilateral sensorimotor cortex region. The total magnetic stimulation therapy lasted about 30 min a day, and was applied 5 days/week for 4 weeks. Results After 4 weeks’ treatment, the patient’s Fulg–Meyer upper limb assessment (FMA) score was obviously improved (from 27 to 37 points), and the spasm was largely relieved in his right hand and arm. Conclusion Peripheral plus central rTMS might be an effective treatment for motor dysfunction of chronic stroke patients. Keywords Motor dysfunction; Magnetic stimulation; Upper limb rehabilitation Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.499 ISPR8-0014
Long-term functional outcomes of stroke patients
R. Suksathien ∗ , T. Sukpongthai Maharat Nakhon Ratchasima Hospital, Department of Rehabilitation Medicine, Nakhon Ratchasima, Thailand ∗ Corresponding author. E-mail address: [email protected] (R. Suksathien) Introduction/Background Predictors of functional outcomes of stroke patients are important for providing efficient post-stroke care according to the degree of impairment. The authors attempted to use the data that are routinely recorded in acute stroke care to determine long-term functional outcomes of stroke patients. Material and method This analytic study examined the longterm functional outcomes of stroke patients admitted to Maharat Nakhon Ratchasima Hospital with acute stroke between January 1 and December 31, 2015. We recorded patients’ characteristic data and functional level on admission using Barthel index (BI) score. Long-term functional outcomes were evaluated with BI score at least 6 months after stroke onset by telephone interview and medical records. The predictors of long-term functional outcomes were determined with stepwise multiple logistic regression analysis. Results Of the 907 patients, 191 (21%) died during acute stroke admission, 117 (13%) died after and 210 (23%) were lost to followup and could not be contacted. There were 5 variables significantly correlated with good functional outcomes after multiple logistic regression analysis. Subjects aged 55 or under, male, admission BI score 30–100, muscle power grade 0–1 and with consciousness problems had adjusted odds ratios of 12.56, 3.78, 3.33, 0.28 and 0.24, respectively. Four variables correlated with poor functional outcomes were impaired consciousness, age over 65, more than 3 comorbidities, and admission BI score of 0–30 had adjusted odds ratios of 4.83, 4.08, 2.39, and 1.89 respectively. Conclusion Long-term functional outcomes of stroke patients were associated with age, consciousness, gender, muscle power, admission BI score and number of comorbidities. Keywords Stroke; Predictors; Long-term functional outcomes Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.500
ISPR8-2571
Effects of physical therapies aiming directly or indirectly at the recovery of balance after stroke. A meta-analysis A. Hugues 1,2,∗ , J. Di-Marco 3 , P. Janiaud 4 , Y. Xue 5,6 , J. Zhu 7 , J. Pires 8 , H. Khademi 9 , L. Rubio 10 , P. Hernandez Bernal 11 , Y. Bahar 12 , H. Charvat 13 , P. Szulc 14 , C. Ciumas 15,16 , H. Won 17,18 , M. Cucherat 4 , I. Bonan 19 , F. Gueyffier 20 , G. Rode 1,2 1 Hospices Civils de Lyon, Centre de Recherche de Neurosciences de Lyon, Université de Lyon, Lyon, France 2 Service de Médecine Physique et de Réadaptation, Hôpital Henry Gabrielle, Unité Impact, Plate-forme « Mouvement et Handicap », Saint-Genis Laval, France 3 Assistance publique–Hôpitaux de Paris, Université Paris Descartes, Service de Médecine Physique et de Réadaptation, Paris, France 4 CNRS Lyon, Université de Lyon 1, UMR 5558, Lyon, France 5 Université de Lyon, Université Claude-Bernard Lyon 1, 69008 Lyon, France 6 Université Saint-Étienne, HESPER EA 7425, 42023 Saint-Étienne, France 7 Université Jiaotong de Shanghai, Pharmacologie, Shanghai, China 8 Medicine Faculty of Oporto University, Rovisco Pais Rehabilitation Centre, Tocha and Oporto, Portugal 9 World Heath Organisation, International Agency of Research on Cancer, Lyon, France 10 Centro Lescer, Rehabilitation, Madrid, Spain 11 Rehaklinik Zihlschlach, Neurologisches Rehabilitationszentrum, Zihlschlacht, Switzerland 12 Hitit University Erol Olcok Training and Research Hospital, Physical Medicine and Rehabilitation, Corum, Turkey 13 Center for Public Health Sciences, National Cancer, Division of Prevention, Tokyo, Japan 14 Inserm, University of Lyon, UMR 1033, Lyon, France 15 Inserm U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon, Université de Lyon, Institute of Epilepsies, Lyon, France 16 Centre Hospitalier Universitaire Vaudois, Translational and Integrative Group in Epilepsy Research TIGER, Department of Clinical Neurosciences, Lausanne, Switzerland 17 Université Grenoble Alpes, UMR 5316 Litt&Arts, Grenoble, France 18 KyungHee University, Séoul, Republic of Korea 19 CHU de Rennes, Service de médecine physique et de réadaptation, Rennes, France 20 Hospices Civils de Lyon, CNRS Lyon, Université de Lyon 1, Service Hospitalo-Universitaire de Pharmaco-Toxicologie, UMR 5558, Lyon, France ∗ Corresponding author. E-mail address: [email protected] (A. Hugues) Introduction/Background After stroke, standing balance is usually described as a predictor of functional recovery. Regarding literature, various type of physical therapy (PT) is used to improve balance. The aim of this meta-analysis is to evaluate the effects of PT directly focused on balance training (DFBT) and theses of PT indirectly focused on balance training (IFBT) on balance after stroke. Material and method Randomised controlled trials (RCT), without language restriction, until October 2015, assessing the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke, the posturographic parameters in static condition and measures of independence in activities of daily living were included. Two independent authors (AH and JDM) led this selection following the Cochrane recommendations (Hugues et al., 2017). Results One hundred and ninety-three parallel and crossover RCT from 9337 records were included, involving 8018 subjects [study sample: mean 41.5 (SD 49.7) subjects, age: pooled mean 61.7 (pooled SD 12.78) years]. A significant difference in favor of PT compared to no treatment was immediately found after the intervention for the BBS (DFBT: 7 studies, mean difference [MD] 1.38; 95% confidence interval [CI] [0.71; 2.05]. IFBT: 18 studies, MD 1.88;