An investigation of the factors that influence functional improvement in stroke rehabilitation

An investigation of the factors that influence functional improvement in stroke rehabilitation

Background/aim: The purpose of this study was to determine effect of age, sex, affected extremity, disability severity, treatment type, cerebrovascular accident (CVA) etiology, number of treatment sessions, and CVA duration on the functional improvement of the stroke patients who participated in a physical medicine and rehabilitation program. Materials and methods: The research sample consisted of 322 stroke patients. Clinical and demographic features including age, sex, affected extremity, disability severity, treatment type, CVA etiology, number of treatment sessions, and CVA duration were recorded. Functional status was evaluated retrospectively by using the functional independence measure (FIM) at admission and discharge. Results: It was detected that discharge FIM score of the patients exhibited an increase of significance level (p < 0.05). It was found that age, number of treatment sessions, CVA duration and FIM admission score were determinative parameters in FIM gain level (p < 0.05) while sex, affected extremity, and CVA etiology were not effective in FIM gain level (p > 0.05). Conclusion: Results show that functional improvement after rehabilitation was better in the younger ages, shorter CVA durations and moderate functional disturbances. The findings obtained may be useful for stroke rehabilitation triage.Key words: Recovery, cerebrovascular accident, outcomes

___

  • 1. Force WT. Report of the WHO task force on stroke and other cerebrovascular disorders. Recommendations on stroke prevention, diagnosis and therapy. Stroke 1989; 20 (10): 1407- 1431. doi: 10.1161/01.str.20.10.1407
  • 2. Feigin VL, Lawes CM, Bennett DA, Anderson CS. Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. The Lancet Neurology 2003; 2 (1): 43-53. doi: 10.1016/s1474- 4422(03)00266-7
  • 3. Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet 2011; 377 (9778): 1693-1702. doi: 10.1016/S0140- 6736(11)60325-5
  • 4. Olsen T. Improvement of function and motor impairment after stroke. Neurorehabilitation and Neural Repair 1989; 3 (4): 187- 192. doi: 10.1177/136140968900300403
  • 5. Carod-Artal FJ, Medeiros MSM, Horan TA, Braga LW. Predictive factors of functional gain in long-term stroke survivors admitted to a rehabilitation programme. Brain Injury 2005; 19 (9): 667-673. doi: 10.1080/02699050400013626
  • 6. Inouye M, Hashimoto H, Mio T, Sumino K. Influence of admission functional status on functional change after stroke rehabilitation. American Journal of Physical Medicine & Rehabilitation 2001; 80 (2): 121-125. doi: 10.1097/00002060- 200102000-00008
  • 7. Macciocchi SN, Diamond PT, Alves WM, Mertz T. Ischemic stroke: relation of age, lesion location, and initial neurologic deficit to functional outcome. Archives of Physical Medicine and Rehabilitation 1998; 79 (10): 1255-1257. doi: 10.1016/ s0003-9993(98)90271-4
  • 8. Kelly PJ, Furie KL, Shafqat S, Rallis N, Chang Y et al. Functional recovery following rehabilitation after hemorrhagic and ischemic stroke. Archives of Physical Medicine and Rehabilitation 2003; 84 (7): 968-972. doi: 10.1016/s0003- 9993(03)00040-6
  • 9. Ween JE, Alexander MP, D’Esposito M, Roberts M. Factors predictive of stroke outcome in a rehabilitation setting. Neurology 1996; 47 (2): 388-392. doi: 10.1212/wnl.47.2.388
  • 10. Jørgensen HS, Reith J, Nakayama H, Kammersgaard LP, Raaschou HO et al. What determines good recovery in patients with the most severe strokes? The Copenhagen Stroke Study. Stroke 1999; 30 (10): 2008-2012. doi: 10.1161/01.str.30.10.2008
  • 11. Eskiyurt N, Yalıman A, Vural M, Kızıltaş H, Bölükbaş N et al. Characteristics and functional outcomes of stroke patients. Journal of İstanbul Faculty of Medicine 2005; 68 (3): 71-77 (article in Turkish with an abstract in English).
  • 12. Balcı B, Ertekin Ö, Kara B, Erdem Y. The effects of inpatient rehabilitation program in acute stroke patients. Journal of Neurological Sciences [Turkish] 2011; 28 (2): 142-154 (article in Turkish with an abstract in English).
  • 13. Luk JKH, Cheung RTF, Ho SL, Li L. Does age predict outcome in stroke rehabilitation? A study of 878 Chinese subjects. Cerebrovascular Diseases 2006; 21 (4): 229-234. doi: 10.1159/000091219
  • 14. Wade DT, Langton-Hewer R,Wood VA. Stroke: the influence of age upon outcome. Age and Ageing 1984; 13 (6): 357-362. doi: 10.1093/ageing/13.6.357
  • 15. Luk JKH, Chiu PKC, Chu LW. Gender differences in rehabilitation outcomes among older Chinese patients. Archives of Gerontology and Geriatrics 2011; 52 (1): 28-32. doi: 10.1016/j.archger.2010.01.016
  • 16. Robinson-Smith G, Johnston MV, Allen J. Self-care selfefficacy, quality of life, and depression after stroke. Archives of Physical Medicine and Rehabilitation 2000; 81 (4): 460-464. doi: 10.1053/mr.2000.3863
  • 17. Küçükdeveci AA, Yavuzer G, Elhan AH, Sonel B, Tennant A. Adaptation of the functional independence measure for use in Turkey. Clinical Rehabilitation 2001; 15 (3): 311-319. doi: 10.1191/026921501676877265
  • 18. Alexander MP. Stroke rehabilitation outcome. A potential use of predictive variables to establish levels of care. Stroke 1994; 25 (1): 128-134. doi: 10.1161/01.str.25.1.128
  • 19. Lin JH, Hsiao SF, Chang CM, Huang MH, Liu CK et al. Factors influencing functional independenceoutcome in stroke patients after rehabilitation. Kaohsiung Journal of Medical Sciences 2000; 16 (7): 351-359.
  • 20. Cakir T, Sarier RN, Dogan SK, Toraman NF. Factors affecting the Functional Independence Measure gain of patients with stroke. Turkish Journal of Physical Medicine and Rehabilitation 2015; 61 (1): 30-35. doi: 10.5152/tftrd.2015.78045
  • 21. Nakipoğlu-Yüzer GF, Doğan-Aslan M, Doğan A, Özgirgin N. The effect of the stroke etiology on functional improvement in our geriatric hemiplegic patients. Journal of Stroke and Cerebrovascular Diseases 2010; 19 (3): 204-208. doi: 10.1016/j. jstrokecerebrovasdis.2009.04.008
  • 22. Paolucci S, Antonucci G, Grasso MG, Morelli D, Troisi E et al. Early versus delayed inpatient stroke rehabilitation: a matched comparison conducted in Italy. Archives of Physical Medicine and Rehabilitation 2000; 81 (6): 695-700. doi: 10.1016/s0003- 9993(00)90095-9
  • 23. Yavuzer G, Küçükdeveci A, Arasil T, Elhan A. Rehabilitation of stroke patients: clinical profile and functional outcome. American Journal of Physical Medicine & Rehabilitation 2001; 80 (4): 250-255. doi: 10.1097/00002060-200104000-00003
  • 24. Granger CV, Hamilton BB, Fiedler RC. Discharge outcome after stroke rehabilitation. Stroke 1992; 23 (7): 978-982. doi: 10.1161/01.str.23.7.978
  • 25. Desrosiers J, Bourbonnais D, Bravo G, Roy PM, Guay M. Performance of the unaffected upper extremity of elderly stroke patients. Stroke 1996; 27 (9): 1564-1570. doi: 10.1161/01. str.27.9.1564
  • 26. Öz B, Koca B, Ölmez N, Memiş A. Factors associated with functional and cognitive improvement in patients with stroke after rehabilitation. Turkish Journal of Physical Medicine and Rehabilitation 2008; 54 (3): 84-89 (article in Turkish with an abstract in English).
  • 27. Ring H, Feder M, Schwartz J, Samuels G. Functional measures of first-stroke rehabilitation inpatients: usefulness of the functional independence measure total score with a clinical rationale. Archives of Physical Medicine and Rehabilitation 1997; 78 (6): 630-635. doi: 10.1016/s0003-9993(97)90429-9
  • 28. Gokkaya N, Aras M, Cardenas D, Kaya A. Stroke rehabilitation outcome: the Turkish experience. International Journal of Rehabilitation Research 2006; 29 (2): 105-111. doi:10.1097/01. mrr.0000191852.03317.2b
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: 6
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Comparison of frozen-thawed embryo transfer protocols in patients with previous cycle cancellation due to uterine peristalsis: a pilot study

Funda CEVHER, İlknur SELVİ, Cengiz KARAKAYA, Mehmet ERDEM, Erhan DEMİRDAĞ, Ahmet ERDEM

Impact of hospital-acquired acute kidney injury on Covid-19 outcomes in patients with and without chronic kidney disease: a multicenter retrospective cohort study

Mustafa ARICI, Nurhan SEYAHİ, Erkan ŞENGÜL, Kenan TURGUTALP, Mürşide Esra DÖLARSLAN, Savaş ÖZTÜRK, Feyza BORA, Tuba Elif ÖZLER, Yavuz AYAR, Ali Rıza ODABAŞ, Kenan ATEŞ, Ekrem KARA, Mehmet Rıza ALTIPARMAK, Savaş SİPAHİ, Serkan BAKIRDÖĞEN, Özkan GÜNGÖR, Hakkı ÇETİNKAYA, Zeki AYDIN, Zeki SOYPAÇACI, İdr

Pancreas and kidney changes in type 2 diabetes patients: the role of diffusion-weighted imaging

Adil DOĞAN, Adnan ÖZDEMİR, Mehmet Hamdi ŞAHAN, Yasemin Mirace KARADENİZ BİLGİLİ, Neşe ASAL, Aşkın GÜNGÜNEŞ

Prevalence of comorbidities and associated factors in acromegaly patients in the Turkish population

Mustafa KULAKSIZOĞLU, Mustafa CAN, İlker ÇORDAN, Muhammet KOCABAŞ, Melia KARAKÖSE, Hatice ÇALIŞKAN BURGUCU, Feridun KARAKURT

Lack of awareness of Hepatitis B screening and vaccination in high-risk group

Alpaslan ALP, Cem ŞİMŞEK, Osman DAĞ, Tolga YILDIRIM, Abdullah Tarık ASLAN, Şefika AYAR, Cavanşir VAHABOV, Hakan GÖKER, Yahya BÜYÜKAŞIK, Halis ŞİMŞEK, H. Yasemin BALABAN

The assessment of the effect of different intraabdominal pressures used for laparoscopic cholecystectomy surgery on optic nerve sheath diameter: a prospective observational cohort study

Tuna ERTÜRK, Bülent Barış GÜVEN, Ayşın ERSOY, Yadigar YILMAZ, Fulya YURTSEVER

Could serum albumin value and thrombocyte/lymphocyte ratio be an important prognostic factor in determining the severity of COVID 19?

Mehmet Can EZGÜ, Gürhan TAŞKIN, Cumhur ARTUK, Yakup ARSLAN, Serdar YAMANYAR, Alparslan MERDİN, Emel UYAR, Serkan CERİTLİ

Covid-19 scientific publications from Turkey

Rafiye ÇİFTÇİLER, Abdurrahman TUFAN, Mehmet Akif ÖZTÜRK, İbrahim C. HAZNEDAROĞLU

Impact of fetal brain tissue derived mesenchymal stem cell and fibrin glue on facial nerve crash injury

Gülistan Sanem SARIBAŞ, Sevilay KARAHAN, Güleser SAYLAM, Ömer BAYIR, Mehmet Hakan KORKMAZ, Kemal KESEROĞLU, Bülent ÖCAL, Emel ÇADALLI TATAR, Tuğba KARAGÖZ, Ferda ALPASLAN PINARLI, Candan ÖZOĞUL

Prone versus Barts “flank-free” modified supine percutaneous nephrolithotomy: a match-pair analysis

Murat KESKE, Mehmet YILDIZHAN, Taha ÇETİN, Mehmet YİĞİT YALÇIN, Arslan ARDIÇOĞLU3, Davut KAMACI, Uygar MİÇOOĞULLARI, Özer Ural ÇAKICI, Furkan UMUT KILIÇ