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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to determine if age is significant in functional recovery in acute, traumatic central cord syndrome (CCS). Recovery of ambulation, ADL status, and bowel and bladder function were evaluated. A retrospective study tested the hypothesis that functional recovery in 51 consecutive CCS patients was better in younger patients than in older patients. Four patients, all more than 50 years, died. Ability to ambulate independently at discharge was compared in 30 patients younger than 50 years with 21 patients 50 years or older. Results showed that 29 of 30 (97%) of the younger patients were ambulatory compared to seven of 17 (41%) of the older patients (p less than .002). The younger patients were also able to achieve independence in self-care and bowel and bladder function in a significantly greater proportion. The prognosis for functional recovery in acute traumatic CCS should consider the patient's age. The prognosis is less optimistic in older patients, but it is considerably more favorable in younger patients than previously reported.
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PMID:Age effect on prognosis for functional recovery in acute, traumatic central cord syndrome. 224 42

Of the 373 stroke patients 95 were admitted to the feasibility study of stroke rehabilitation. The patients were divided into two groups, an intensive and a normal treatment group. In this study, the functional recovery of stroke, measured by ADL and motor function was significantly better in the intensive treatment group. There was no difference in institutionalization or incidence of death between the groups. The gain of ADL and motor function was greatest during the first three months after stroke in the intensive treatment group. The conclusion is that intensified physiotherapy seems to improve the functional recovery of stroke patients.
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PMID:The significance of intensity of rehabilitation of stroke--a controlled trial. 391 6

We performed semi-quantitative SPECT scans using 99mTcm-HMPAO on 34 elderly subjects 10-15 days after ischaemic stroke. Each cerebral hemisphere was divided into five regions of interest. Asymmetry scores were determined for ten slices in each region using activity ratios to the other hemisphere and to the ipsilateral cerebellum. Outcome was assessed by maximal Barthel ADL score during the first two months after stroke. Asymmetry scores in the hemisphere involved by the stroke event were much higher than those in the opposite hemisphere. Subjects with poor outcome (maximal Barthel 0-12) had significantly higher asymmetry scores than those with good outcome (Barthel 13-20). The total asymmetry score (both hemispheres) and the score of the involved hemisphere predicted Barthel ADL score in a general linear model. Total asymmetry score remained a significant predictor of maximal Barthel score in multivariate models. Thus semi-quantitative SPECT scanning is of value in predicting functional recovery after stroke.
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PMID:Semi-quantitative SPECT scanning in acute ischaemic stroke. 824 66

Fifty-six consecutive elderly ( > or = 65 years) patients, admitted for acute stroke to a geriatric department were included in the study and underwent CT scanning. Functional status was graded according to the modified Rankin scale. Three patients had primary intra-cerebral haemorrhage, 22 deep hemispheric infarct, 17 had anterior circulation cortical infarcts, five had posterior circulation infarcts and in nine the CT scan was normal. Stroke risk factors were equally distributed among the different CT scan groups, and all three larger groups had similar rates of non-neurological major complications including death (41%). However, independence in ADL (Rankin 0-2) was observed in 72% of deep infarct survivors, but only 15% of the cortical infarct group (p = 0.00018). For the normal scan group, functional recovery was intermediate. In the cortical infarct group patients with an infarct of > or = 50 mm mean diameter (five cases) should worse functional recovery than did eight patients with small infarcts. The mean difference between pre- and post-stroke Rankin score (DR) was 3.4 for the larger infarct patients and 1.9 for the smaller infarct group (p = 0.027). Pearson correlation revealed a direct relationship between the infarction size and DR (p = 0.039). Such a relationship was not observed for the deep hemispheric group.
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PMID:The importance of brain infarct size and location in predicting outcome after stroke. 858 43

Research articles on the prognosis of stroke patients were analysed to identify studies that met sound methodological principles of prognostic research as well as to identify variables capable of predicting functional outcome (ADL) after stroke. Data sources comprised a computer-aided search of published prognostic studies and references to literature used in prognostic studies. Seventy-eight studies were tested for adherence to the following key methodological criteria: reliability and validity of measurement instruments used to assess dependent and independent variables; inclusion of an inception cohort; adequate and uniform end-point of observation; control for drop-outs during period of observation; statistical testing of presumed relationship between dependent and independent variables; sufficient sample size in relation to number of determinants; control for multicollinearity; specification of patient characteristics (i.e. age, type, recurrent stroke and localization of stroke); description of interfering treatment effects during the period of observation, and cross-validation of the prediction model in a second independent group of patients. Only three studies satisfied nine out 11 criteria and ten studies eight criteria for the determination of valid prognostic research. The results of these studies indicate that the following variables are valid predictors for functional recovery after stroke: age; previous stroke; urinary continence; consciousness at onset; disorientation in time and place; severity of paralysis; sitting balance; admission ADL score; level of social support and metabolic rate of glucose outside the infarct area in hypertensive patients. This study supports the general opinion that not only are differences in objectives and heterogeneity in stroke patients responsible for the lack of accuracy in predicting functional outcome, but also the methodological flaws in published prognostic research.
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PMID:Predicting disability in stroke--a critical review of the literature. 900 86

This study examined the stroke knowledge of 60 stroke rehabilitation patients, 46 spouses, 25 family members, and 103 people in the general community. Changes in stroke knowledge with time, and determinants of stroke knowledge, were also examined. Clinical participants were assessed on acute admission, admission to and discharge from rehabilitation, and 6 and 12 months after discharge. Community participants were assessed once. Instruments used were the Stroke Care Information Test, Australian ADL Index, Frenchay Activities Index, Illness Behaviour Questionnaire and Zung Self-rating Depression Scale. The stroke knowledge of all participants, particularly patients, was poor, but improved with time. Better-informed patients were younger, had milder strokes, were less depressed, were less likely to develop abnormal illness behaviour, and made a better functional recovery than patients with poorer knowledge. Structured information programmes are needed for stroke patients and their families. Improved community awareness of stroke may help the prospects for recovery and quality of life for people who have strokes.
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PMID:Knowledge of stroke in rehabilitation and community samples. 954 20

The objective of the study was to assess the utility of the Frenchay Activities Index (FAI) to measure instrumental activities of daily living (IADL) and functional recovery in stroke patients compared to other measures such as Barthel Index (BI) and Scandinavian Stroke Scale (SSS). A cross-sectional descriptive analysis design was done. Ninety stroke survivors (41 women, 49 men; mean age 68 years) discharged from the Stroke Unit at San Carlos Hospital, Madrid, were assessed by BI at discharge and by BI and FAI 1-year after stroke. At discharge, 40% had total or severe disability (BI < or =60) and at 1-year 11.1%. FAI (mean value 36 +/ 11) correlated with Barthel index, capacity for walking, strength in upper limb and total SSS 1-year after stroke (p < 0.0001). Fifty-two per cent of stroke patients became independent in their ADL during the first year. BI was the strongest predictor of independence in FAI Social activities-category.
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PMID:Functional recovery and instrumental activities of daily living: follow-up 1-year after treatment in a stroke unit. 1187 14

Age is the most important risk factor for developing a stroke. In addition, age may also influence stroke recovery. To allow structured discharge planning, it may be important to consider the influence of age on stroke recovery during the early phase. We studied the effect of patient age on early stroke recovery in a cohort of 2219 unselected stroke patients. Data on functional status (Barthel Index Score) were collected prospectively within 24h after admission, after one week and at discharge for 2219 acute stroke patients treated in 1999 and 2000 at 7 neurological departments in the county of Hesse, Germany. Multiple regression analyses were used to test for an association between age, relative recovery and speed of recovery of ADL after stroke. More than half of the patients (58 %) improved in functional status during hospitalization. 37 % had no change in Barthel Index score and only a small number of patients (5 %) deteriorated during this period. Relative improvement decreased with increasing age: patients younger than 55 years showed an improvement of 67 % of the maximum possible improvement compared whith only 50 % for patients above 55 years (adjusted R(2) = 0.120, beta(age) = -0.130, p < 0.001). Age only had a small effect on the speed of recovery. For younger patients functional recovery was slightly faster (adjusted R(2) = 0.256, beta(age) = -0.080, p < 0.001). Despite its strong influence on case fatality, age is a poor predictor of functional recovery during the very early phase after stroke. Resulting functional recovery depends much more on the extent of the initial disability. Advanced age should not be regarded as a limiting factor in the early rehabilitation of stroke patients.
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PMID:Does age influence early recovery from ischemic stroke? A study from the Hessian Stroke Data Bank. 1279 28

The Dynamic Hip Screw (DHS) is currently the most frequently used implant for the treatment of pertrochanteric hip fractures. The Percutaneous Compression Plate (PCCP) is a recently developed, alternative device that involves minimal invasive surgery. The objective of the present study was to compare functional recovery following these two surgical procedures. A total of 76 consecutive elderly subjects (mean age and standard deviation, 80.6 +/- 5.5) following pertrochanteric hip fracture fixation were evaluated prospectively. Functional recovery was assessed 3 and 12 weeks and 2 years following surgery. Differences between groups 3 weeks postsurgery were found only in pain level during ambulation and in the weight-bearing capability of the operated extremity, which were both in favor of the PCCP. By 3 months, both groups had improved in all measures, but did not reach their preinjury level of independence. However, the PCCP group ambulated with fewer assistive devices and demonstrated better recovery of basic activities of daily living (BADL). While the majority of the subjects from both groups ambulated independently 2 years postsurgery, the PCCP group exhibited less pain during ambulation, was more independent in ADL, and required fewer assistive devices for ambulation. To summarize, the PCCP presents enhanced short- and long-term recovery of functional abilities in comparison to DHS. However, given the limited number of patients, further studies are necessary to substantiate these results.
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PMID:Functional recovery following pertrochanteric hip fractures fixated with the Dynamic Hip Screw vs. the percutaneous compression plate. 1579 82

The objectives of study were to identify longitudinal ADL profiles and to investigate profiles characteristics of participants in stroke rehabilitation programme. 496 stroke rehabilitation records in one year were retrieved. Patients' demographics, admission scores of Cantonese version of Mini-mental State Examination and line cancellation test were retrieved. Chinese version of the Modified Barthel Index (MBI-C) records for the first four successive weeks were also obtained for cluster analysis. Four functional profiles were yielded after cluster analysis. Repeated measures ANOVA showed that Profile 1 (n = 168) with oldest age, lowest baseline MBI-C and line cancellation test scores had improvement only at the last two measurement points (p < 0.001). Profile 4 (n = 100) with youngest age and highest baseline MBI-C showed progress for the first two assessment points then slowing down progressively, while the other two profiles showed improvement on all measurement points (p < 0.001) but with different baseline MBI-C and increments. One-way ANOVA further revealed significant differences in demographics, cognitive-perceptual and receptive speech functions among the profiles. The present study revealed different recovery potential among people with stroke. The higher the initial ADL performance, younger age and the absence of unilateral neglect appeared to relate to better functional recovery.
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PMID:Profiles of functional outcomes in stroke rehabilitation for Chinese population: a cluster analysis. 1982 44


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