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Ikeda K, Kaneko T, Uchida J, Nakamura T, Takeda T, Nagayama H. Identifying profiles of stroke patients benefitting from additional training: a latent class analysis approach. J Rehabil Med 2024; 56:jrm22141. [PMID: 38380814 DOI: 10.2340/jrm.v56.22141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVE To identify profiles of stroke patient benefitting from additional training, using latent class analysis. DESIGN Retrospective observational study. PATIENTS Patients with stroke (n = 6,875) admitted to 42 recovery rehabilitation units in Japan between January 2005 and March 2016 who were registered in the Japan Association of Rehabilitation Database. METHODS The main outcome measure was the difference in Functional Independence Measure (FIM) scores between admission and discharge (referred to as "gain"). The effect of additional training, categorized as usual care (no additional training), self-exercise, training with hospital staff, or both exercise (combining self-exercise and training with hospital staff), was assessed through multiple regression analyses of latent classes. RESULTS Applying inclusion and exclusion criteria, 1185 patients were classified into 7 latent classes based on their admission characteristics (class size n = 82 (7%) to n = 226 (19%)). Patients with class 2 characteristics (right hemiparesis and modified dependence in the motor-FIM and cognitive-FIM) had positive FIM gain with additional training (95% confidence interval (95% CI) 0.49-3.29; p < 0.01). One-way analysis of variance revealed that training with hospital staff (95% CI 0.07-16.94; p < 0.05) and both exercises (95% CI 5.38-15.13; p < 0.01) led to a significantly higher mean FIM gain than after usual care. CONCLUSION Additional training in patients with stroke with right hemiparesis and modified dependence in activities of daily living was shown to improve activities of daily living. Training with hospital staff combined with self-exercise is a promising rehabilitation strategy for these patients.
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Affiliation(s)
- Kohei Ikeda
- Kanagawa University of human Services, Faculty of Health and Social Service, School of Rehabilitation, Division of Occupational Therapy Program, Yokosuka, Kanagawa, Japan.
| | - Takao Kaneko
- Department of Rehabilitation, Yamagata prefectural central hospital, Yamagata, Japan
| | - Junya Uchida
- Department of Rehabilitation Therapy, Saiseikai Higashikanagawa Rehabilitation Hospital, Yokohama, Japan
| | - Takuto Nakamura
- Kanagawa University of human Services, Faculty of Health and Social Service, School of Rehabilitation, Division of Occupational Therapy Program, Yokosuka, Kanagawa, Japan
| | - Taisei Takeda
- Department of Rehabilitation Therapy, Saiseikai Higashikanagawa Rehabilitation Hospital, Yokohama, Japan
| | - Hirofumi Nagayama
- Kanagawa University of human Services, Faculty of Health and Social Service, School of Rehabilitation, Division of Occupational Therapy Program, Yokosuka, Kanagawa, Japan
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The effects of exercise intervention on cognition and motor function in stroke survivors: a systematic review and meta-analysis. Neurol Sci 2023; 44:1891-1903. [PMID: 36781567 DOI: 10.1007/s10072-023-06636-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/20/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Cognitive impairment was a common sequela among stroke survivors, and exercise intervention was a promising non-pharmacological treatment modality for it. PURPOSE To explore the effects of exercise intervention programs on cognitive and motor function in patients with cognitive impairment after stroke. STUDY DESIGN Systematic review and meta-analysis. METHODS Seven online databases (PubMed, Embase, Cochrane Library, Web of Science, Scopus, PsycInfo, and SPORTDiscus) were searched from their inception to 10 February 2022. Randomised controlled trials (RCTs) comparing the effects of exercise with non-exercise rehabilitation, using the Montreal Cognitive Assessment, Addenbrooke's Cognitive Examination, Mini-Mental State Examination, Trial Making Test, Upper and Lower Extremity Fugl-Meyer Assessment, Berg Balance Scale, and Barthel Index, were selected. Calculations for each assessment were performed for the overall effect and the therapy of interest, taking into account the effect of stroke severity or stimulus parameters. RESULTS Twelve RCTs involving 975 participants and investigating nine different types of exercise interventions were included. The results were not affected by participant characteristics or reactive balance outcomes. Our results emphasise the importance of lightweight and operable aerobic exercises. Exercise itself had a high potential to improve cognitive impairment and motor function after stroke. CONCLUSIONS Exercise had significant positive effects on alleviating cognitive and motor impairments after stroke.
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Zhang Y, Qiu X, Chen J, Ji C, Wang F, Song D, Liu C, Chen L, Yuan P. Effects of exercise therapy on patients with poststroke cognitive impairment: A systematic review and meta-analysis. Front Neurosci 2023; 17:1164192. [PMID: 37090811 PMCID: PMC10117650 DOI: 10.3389/fnins.2023.1164192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/09/2023] [Indexed: 04/25/2023] Open
Abstract
Objective To evaluate the effects of exercise therapy on patients with poststroke cognitive impairment and compare the differences in the effect of this method when compared with conventional measures, providing evidence for a more standardized and effective clinical application of exercise therapy. Methods A search was conducted using 7 electronic databases, including PubMed, CINAHL, Web of Science, CENTRAL, CNKI, Wanfang, SinoMed, and clinical trials registry platforms for randomized controlled trials concerning exercise therapy on patients with poststroke cognitive impairment. Two researchers independently screened the literature, evaluated the quality, and extracted information. Meta-analysis was carried out using Review Manager 5.4 software. Results There were 11 studies with 1,382 patients. Meta-analysis showed that exercise therapy could improve cognitive function [SMD = 0.67, 95% CI (0.31, 1.04), P = 0.0003], motor function [SMD = 1.81, 95% CI (0.41, 3.20), P = 0.01], and the activities of daily living [MD = 8.11, 95% CI (3.07, 13.16), P = 0.002] in patients with poststroke cognitive impairment. Conclusion Exercise therapy can not only improve cognitive function in patients with poststroke cognitive impairment but also improve motor function and the activities of daily living. Medical staff should prioritize the management of patients with poststroke cognitive impairment and carry out exercise therapy actively to improve the cognitive function of patients with stroke. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42023397553.
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Affiliation(s)
- Yuanxing Zhang
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xichenhui Qiu
- Health Science Center, Shenzhen University, Shenzhen, China
| | - Jinghao Chen
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Cuiling Ji
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Fang Wang
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Dan Song
- Nursing Department, Shenzhen Shekou People's Hospital, Shenzhen, China
| | - Caiyan Liu
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lu Chen
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
- *Correspondence: Lu Chen
| | - Ping Yuan
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
- Ping Yuan
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Yamaura R, Kaneko T, Ishikawa KB, Ikeda S, Fushimi K, Yamazaki T. Factors Associated With Time to Achieve Physical Functional Recovery in Patients With Severe Stroke After Inpatient Rehabilitation: A Retrospective Nationwide Cohort Study in Japan. Arch Rehabil Res Clin Transl 2022; 4:100229. [PMID: 36545532 PMCID: PMC9761254 DOI: 10.1016/j.arrct.2022.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
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.
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Affiliation(s)
- Reiko Yamaura
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Tetsuji Kaneko
- Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
- Teikyo Academic Research Center, Teikyo University, Tokyo, Japan
| | - Koichi Benjamin Ishikawa
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | - Shunya Ikeda
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Tsutomu Yamazaki
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
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Anmoto N, Takebayashi T, Okita Y, Ishigaki M, Hibino S, Hanada K. Effectiveness of combining robotic therapy and modified constraint-induced movement therapy for moderate to severe upper limb paresis after stroke in subacute phase: Case–control study by propensity score analysis. Br J Occup Ther 2022. [DOI: 10.1177/03080226221121745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Robotic assisted therapy and modified constraint-induced movement therapy are used evidence-based approach in stroke rehabilitation. However, there is no study showing a combination of robotic assisted therapy and modified constraint-induced movement therapy (combined therapy) in the subacute phase. This study investigated the effectiveness of combined therapy in stroke patients with moderate to severe upper limb paresis compared with conventional occupational therapy at subacute setting. Methods: This research used a case–control study. The intervention group ( n = 15) consisting of patients with moderate to severe upper limb paresis (Brunnstrom recovery stage upper extremity III or IV and above hand III) 4–8 weeks since stroke onset received a combined therapy for 3 weeks (total intervention time: 1440 minutes). The control group ( n = 15) extracted by propensity score matching received a conventional occupational therapy for 4 weeks (total intervention time: 1680–2240 minutes). The primary outcome was the Fugl-Meyer assessment upper limb score change before and after the intervention. Results: The intervention group exhibited significantly greater improvement on Fugl-Meyer assessment upper lim change ( p = 0.005). Conclusion: In the subacute phase, the combined therapy of robotic assisted therapy and modified constraint-induced movement therapy helped improve upper limb motor function more effectively and efficiently than conventional occupational therapy.
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Affiliation(s)
- Naoya Anmoto
- Department of Occupational Therapy, Nagoya City Rehabilitation Centre, Nagoya, Japan
| | - Takashi Takebayashi
- Department of Occupational Therapy, School of Comprehensive Rehabilitation, College of Health and Human Sciences, Osaka Prefecture University, Habikino, Japan
| | - Yuho Okita
- Soaring Health Sports, Wellness and Community Centre, Melbourne, Australia
| | - Masakazu Ishigaki
- Department of Lifestyle Support, Home Comprehensive Care Centre Motoasakusa, Medical Corporation Kiseikai, Motoasakusa, Japan
| | - Shin Hibino
- Department of Planning and Research, Nagoya City Rehabilitation Centre, Nagoya, Japan
| | - Keisuke Hanada
- Department of Occupational Therapy, School of Comprehensive Rehabilitation, College of Health and Human Sciences, Osaka Prefecture University, Habikino, Japan
- Department of Rehabilitation, Kinshukai Hanwa Memorial Hospital, Osaka, Japan
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Asanuma D, Momosaki R. Characteristics of rehabilitation services in high-FIM efficiency hospitals after hip fracture. THE JOURNAL OF MEDICAL INVESTIGATION 2020; 66:324-327. [PMID: 31656298 DOI: 10.2152/jmi.66.324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Characteristics of rehabilitation services probably explain a large proportion of the variation in clinical outcomes following hip fracture. The aim of this study was to clarify rehabilitation characteristics of high-performance hospitals after hip fracture. This is a retrospective observational study using the Japan Rehabilitation Database for the period 2005-2015. We divided facilities into high-FIM efficiency and low-FIM efficiency hospitals by using the mean of Functional Independence Measure efficiency for each hospital. We compared rehabilitation characteristics between high- and low-FIM efficiency hospitals. We identified 1247 patients with hip fracture from 12 hospitals who were eligible for analysis after applying exclusion criteria. Using one-to-one random matching on admission Functional Independence Measure, 880 pairs of patients were included for final analysis. More patients were discharged home in the high-FIM efficiency hospitals compared with low-FIM efficiency hospitals. High-FIM efficiency hospitals had significantly shorter length of stay. Patients in high-FIM efficiency hospitals received higher amounts of daily rehabilitation, early rehabilitation, and preoperative rehabilitation. Patients in high-FIM efficiency hospitals engaged in more weekend exercise and self-exercise. Our data suggested that the amount, timing, and type of rehabilitation are essential indicators of performance in acute hip fracture. J. Med. Invest. 66 : 324-327, August, 2019.
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Affiliation(s)
- Daichi Asanuma
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
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Murayama I, Asai T, Misu S, Yamauchi M, Miura A, Ikemura T, Takehisa T, Takehisa Y. Is increased "stay away from bed" time associated with improved clinical rehabilitation outcomes in Japanese rehabilitation hospitals? A prospective observational study and clinical practice. Aging Clin Exp Res 2019; 32:913-920. [PMID: 31327123 PMCID: PMC7190592 DOI: 10.1007/s40520-019-01269-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/04/2019] [Indexed: 11/15/2022]
Abstract
Background A comprehensive team approach for increasing stay away from bed time (SaB-time) called CASaB was conducted at multiple rehabilitation hospitals. Aims The aim of the present study was to investigate the association between SaB-time and clinical rehabilitation outcomes (CROs) before introducing CASaB (observational phase), and comparing CROs before and after CASaB (CASaB phase). Methods This prospective observational study included patients who were admitted to nine rehabilitation hospitals, with complete data. The final analysis included 197/229 patients in the observation phase, and 229/256 patients in the CASaB phase. We first tested whether SaB-time was positively associated with CROs in an observational study, then compared CROs before and after CASaB. Results In the observation phase, longer SaB-time was significantly associated with greater rehabilitation efficiency (REy) after adjusting for confounders (standardized β = 0.20, p = 0.007). In a comparison of CROs before and after CASaB, the length of hospital stay during the CASaB phase was significantly shorter than during the observational phase (61.5, 57.6–65.4 days vs 75.6, 71.4–79.9 days, p < 0.001), and the REy after CASaB was significantly greater than that before the CASaB (0.38, 0.33–0.42/day vs 0.28, 0.25–0.33/day, p = 0.006). Discussion The current results suggest that increasing SaB-time may help the recovery of functional abilities, particularly for patients in rehabilitation hospitals. Conclusions The CASaB provides a method for improving the recovery efficiency of patients in rehabilitation hospitals.
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Kasuga S, Momosaki R, Hasebe K, Sawabe M, Sawaguchi A. Effectiveness of self-exercise on elderly patients after hip fracture : A retrospective cohort study. THE JOURNAL OF MEDICAL INVESTIGATION 2019; 66:178-181. [PMID: 31064934 DOI: 10.2152/jmi.66.178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The purpose of this study was to clarify the impact of self-exercise for elderly patients in an acute hospital after hip fracture. This retrospective observational study used data from the Japan Rehabilitation Database spanning 2005-2015. This study identified in-hospital hip fracture patients admitted to an acute hospital. After applying exclusion criteria, 375 patients were eligible. The primary outcome was motor Functional Independence Measure (FIM) efficiency. Of the patients with hip fracture, 39% performed self-exercises. Patients who performed self-exercise had significantly higher motor FIM efficiency than those who did not (1.22 vs. 0.79 ; P ?0.01). Multivariable regression analysis showed that motor FIM efficiency was significantly and positively correlated with self-exercise (coefficient, 0.25 ; 95% confidence interval, 0.13 to 0.43 ; P ?0.01). The data suggest that self-exercise is associated with good rehabilitation outcomes in hip fracture patients. J. Med. Invest. 66 : 178-181, February, 2019.
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Affiliation(s)
- Seiji Kasuga
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi.,Department of Rehabilitation Medicine, The Jikei University School of Medicine
| | - Kiyotaka Hasebe
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi
| | - Masashi Sawabe
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi
| | - Akira Sawaguchi
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi
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Drigny J, Joussain C, Gremeaux V, Morello R, Van Truc PH, Stapley P, Touzé E, Ruet A. Development and Validation of a Questionnaire to Assess Barriers to Physical Activity After Stroke: The Barriers to Physical Activity After Stroke Scale. Arch Phys Med Rehabil 2019; 100:1672-1679. [PMID: 30684487 DOI: 10.1016/j.apmr.2018.12.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 10/23/2018] [Accepted: 12/19/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To develop and validate a self-reported questionnaire assessing the barriers to physical activity (PA) among stroke survivors. DESIGN Psychometric study. SETTING Ambulatory stroke care. PARTICIPANTS A total of one hundred and forty-six (N=146) individuals were included in this study. In stage 1, community-living stroke survivors (n=37; 13 women) with low-moderate disability (modified Rankin Score 0-3, stroke >3mo) were included. In stage 2, participants (n=109; 40 women) with same characteristics were included. Nine professionals experienced in PA for poststroke patients formed an expert panel. INTERVENTIONS In stage 1, semistructured interviews identified perceived barriers to PA, which were then selected by the expert panel and grouped on a Barriers to Physical Activity After Stroke (BAPAS) scale. In stage 2, stroke participants completed a personal information questionnaire and the BAPAS scale. MAIN OUTCOME MEASURES An item selection process with factor analysis was carried out. The suitability of the data set was analyzed using the Kaiser-Meyer-Olkin coefficient, internal consistency was evaluated by Cronbach α, and concurrent validity was assessed with Spearman correlation coefficients between the BAPAS scale and the modified Rankin Scale. Test-retest repeatability was estimated using 2-way random effects intraclass correlation coefficient model 2,1 at 4-6 day follow-up (n=21). RESULTS Factor analysis supported a 14-item BAPAS that explained 62% of total variance (Kaiser-Meyer-Olkin=0.82) and total score calculated higher than 70 (higher scores for higher barriers). Cronbach α was 0.86, Spearman correlation with the modified Rankin Scale was r=0.65 (P<.001), and test-retest intraclass correlation coefficient was 0.91 (95% CI, 0.79-0.97). The BAPAS scores were higher in patients with greater disabilities and in those with a longer time since the stroke event (P<.01). CONCLUSION We developed and validated the BAPAS scale to assess barriers to PA in stroke survivors with low-moderate disability with promising psychometric properties.
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Affiliation(s)
- Joffrey Drigny
- Service de Médecine Physique et de Réadaptation, CHU de Caen, France.
| | - Charles Joussain
- Université de Versailles St-Quentin en Yvelines, INSERM UMR 1179, Montigny-le-Bretonneux, France
| | - Vincent Gremeaux
- Institute of Sport Sciences of University of Lausanne, Lausanne, Switzerland; Swiss Olympic Medical Center, Sport Medicine Unit, Lausanne University Hospital, Lausanne, Switzerland; CIC-P-INSERM 1432, Technological Platform, University Hospital Dijon, France
| | - Remy Morello
- Unité fonctionnelle de Biostatistique et Recherche Clinique (UBRC) CHU de Caen, France
| | - Patrick H Van Truc
- IMPR du Bois-de-Lébisey, allée des Boisselles, 14200 Hérouville Saint-Clair, France
| | - Paul Stapley
- Neural Control of Movement Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Emmanuel Touzé
- Université de Normandie UNICAEN, INSERM UMR-S U1237, Physiopathologie et imagerie des troubles neurologiques PhIND, Cyceron, Caen, France et Service de Neurologie, CHU de Caen, France
| | - Alexis Ruet
- Service de Médecine Physique et de Réadaptation, CHU de Caen, France; Université de Normandie UNICAEN, INSERM UMR-SU1077, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
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Sawabe M, Momosaki R, Hasebe K, Sawaguchi A, Kasuga S, Asanuma D, Suzuki S, Miyauchi N, Abo M. Rehabilitation Characteristics in High-Performance Hospitals after Acute Stroke. J Stroke Cerebrovasc Dis 2018; 27:2431-2435. [PMID: 29801813 DOI: 10.1016/j.jstrokecerebrovasdis.2018.04.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/20/2018] [Accepted: 04/26/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Rehabilitation characteristics in high-performance hospitals after acute stroke are not clarified. This retrospective observational study aimed to clarify the characteristics of high-performance hospitals in acute stroke rehabilitation. METHODS Patients with stroke discharged from participating acute hospitals were extracted from the Japan Rehabilitation Database for the period 2006-2015. We found 6855 patients from 14 acute hospitals who were eligible for analysis in this study after applying exclusion criteria. We divided facilities into high-performance hospitals and low-performance hospitals using the median of the Functional Independent Measure efficiency for each hospital. We compared rehabilitation characteristics between high- and low-performance hospitals. RESULTS High-performance hospitals had significantly shorter length of stay. More patients were discharged to home in the high-performance hospitals compared with low-performance hospitals. Patients in high-performance hospitals received greater amounts of physical, occupational, and speech therapy. Patients in high-performance hospitals engaged in more self-exercise, weekend exercise, and exercise in wards. There was more participation of board-certified physiatrists and social workers in high-performance hospitals. CONCLUSIONS Our data suggested that amount, timing, and type of rehabilitation, and participation of multidisciplinary staff are essential for high performance in acute stroke rehabilitation.
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Affiliation(s)
- Masashi Sawabe
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan; Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| | - Kiyotaka Hasebe
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
| | - Akira Sawaguchi
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
| | - Seiji Kasuga
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
| | - Daichi Asanuma
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
| | - Shoya Suzuki
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
| | - Narimi Miyauchi
- Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kanagawa, Japan
| | - Masahiro Abo
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
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