Factors Associated With Time to Achieve Physical Functional Recovery in Patients With Severe Stroke After Inpatient Rehabilitation : A Retrospective Nationwide Cohort Study in Japan
© 2022 The Authors..
Objective: To describe characteristics of patient with severe stroke (FIM motor score [FIM motor] 20-49 at admission) and examine association between pre-specified factors (age, sex, modified Rankin Scale before stroke onset, body mass index, FIM motor, and FIM cognitive) and time to achieve FIM motor ≥70, that is, self-independent level.
Design: Retrospective cohort study using a large database in Japan.
Setting: Rehabilitation wards.
Participants: Patients with severe stroke (N=1422) who received inpatient rehabilitation were included (median age: 76 years; interquartile range [IQR]: 68.0-84.0). A total of 54.6% were men, and 65.8% were ischemic stroke.
Interventions: Not applicable.
Main Outcome Measures: Time to achieve FIM motor ≥70.
Results: After inpatient rehabilitation, 40.4% (N=575) achieved FIM motor ≥70 (admission FIM motor 20-29, 30-39 and 40-49: 18.6%, 33.6%, and 47.8%, respectively). Patients who achieved FIM motor ≥70 stayed median 81.0 days [IQR, 51.0-120.0]) and received median: 6.94 units per day [IQR, 5.48-7.78], 1 unit=20 minutes). Adjusted Fine-Gray regression revealed that shorter time to achieve FIM motor ≥70 was associated with higher admission FIM motor (hazard ratio [HR] 2.87 [95% confidence interval [CI] 2.27-3.62]: 20-29 vs 40-49), higher admission FIM cognitive (HR 1.81 [95% CI: 1.39-2.35]: 5-14 vs 25-35), and younger (HR 3.20 [95% CI: 2.32-4.42]: ≥85 years vs 20-69 years).
Conclusions: Most patients with severe stroke did not achieve FIM motor ≥70 after inpatient rehabilitation. Older patients and patients with lower admission FIM motor require more attention. They should be prioritized for state-of-the-art rehabilitation therapy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:4 |
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| Enthalten in: |
Archives of rehabilitation research and clinical translation - 4(2022), 4 vom: 18. Dez., Seite 100229 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yamaura, Reiko [VerfasserIn] |
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| Links: |
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| Themen: |
Activities of daily living |
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| Anmerkungen: |
Date Revised 30.01.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.arrct.2022.100229 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM350571015 |
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| 100 | 1 | |a Yamaura, Reiko |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Factors Associated With Time to Achieve Physical Functional Recovery in Patients With Severe Stroke After Inpatient Rehabilitation |b A Retrospective Nationwide Cohort Study in Japan |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 30.01.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2022 The Authors. | ||
| 520 | |a Objective: To describe characteristics of patient with severe stroke (FIM motor score [FIM motor] 20-49 at admission) and examine association between pre-specified factors (age, sex, modified Rankin Scale before stroke onset, body mass index, FIM motor, and FIM cognitive) and time to achieve FIM motor ≥70, that is, self-independent level | ||
| 520 | |a Design: Retrospective cohort study using a large database in Japan | ||
| 520 | |a Setting: Rehabilitation wards | ||
| 520 | |a Participants: Patients with severe stroke (N=1422) who received inpatient rehabilitation were included (median age: 76 years; interquartile range [IQR]: 68.0-84.0). A total of 54.6% were men, and 65.8% were ischemic stroke | ||
| 520 | |a Interventions: Not applicable | ||
| 520 | |a Main Outcome Measures: Time to achieve FIM motor ≥70 | ||
| 520 | |a Results: After inpatient rehabilitation, 40.4% (N=575) achieved FIM motor ≥70 (admission FIM motor 20-29, 30-39 and 40-49: 18.6%, 33.6%, and 47.8%, respectively). Patients who achieved FIM motor ≥70 stayed median 81.0 days [IQR, 51.0-120.0]) and received median: 6.94 units per day [IQR, 5.48-7.78], 1 unit=20 minutes). Adjusted Fine-Gray regression revealed that shorter time to achieve FIM motor ≥70 was associated with higher admission FIM motor (hazard ratio [HR] 2.87 [95% confidence interval [CI] 2.27-3.62]: 20-29 vs 40-49), higher admission FIM cognitive (HR 1.81 [95% CI: 1.39-2.35]: 5-14 vs 25-35), and younger (HR 3.20 [95% CI: 2.32-4.42]: ≥85 years vs 20-69 years) | ||
| 520 | |a Conclusions: Most patients with severe stroke did not achieve FIM motor ≥70 after inpatient rehabilitation. Older patients and patients with lower admission FIM motor require more attention. They should be prioritized for state-of-the-art rehabilitation therapy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Activities of daily living | |
| 650 | 4 | |a Functional status | |
| 650 | 4 | |a Recovery of function | |
| 650 | 4 | |a Rehabilitation | |
| 650 | 4 | |a Stroke | |
| 700 | 1 | |a Kaneko, Tetsuji |e verfasserin |4 aut | |
| 700 | 1 | |a Ishikawa, Koichi Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Ikeda, Shunya |e verfasserin |4 aut | |
| 700 | 1 | |a Fushimi, Kiyohide |e verfasserin |4 aut | |
| 700 | 1 | |a Yamazaki, Tsutomu |e verfasserin |4 aut | |
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