Deans' stroke musings: Long-term prediction of functional outcome after stroke using single items of the Barthel Index at discharge from rehabilitation centre

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, May 25, 2013

Long-term prediction of functional outcome after stroke using single items of the Barthel Index at discharge from rehabilitation centre

This is stupid, using a secondary measure to predict outcomes. You should be using something objective like how large and where is the dead area.
http://informahealthcare.com/doi/abs/10.3109/09638288.2013.793411

Abstract

Purpose: To determine the prognostic value of single items of the Barthel Index (BI) at discharge from rehabilitation, in predicting independence in personal activities of daily living (ADL) (BI score ≥95/100) at five years after stroke. Method: People with stroke were recruited consecutively from four European rehabilitation centres. BI was assessed on discharge and at five years after stroke. Stepwise multivariate logistic regression analysis was used to determine independent predictors of BI score ≥95/100 at five years after stroke. Thereupon, percentage chance of reaching BI ≥ 95/100 at five years after stroke was calculated. Results: Data were available for 153 patients. Independence in dressing (odds ratio (OR) = 5.22, 95% confidence interval (CI) = 1.85–14.76, p = 0.002) and bathing (OR = 8.10, 95% CI = 3.40–19.32, p < 0.0001) were independent predictors. Independence in both items resulted in 74.1% (57.6–85.8) chance of reaching BI ≥ 95/100 at five years after stroke. Dependence in both items resulted in 6.3% (5.1–7.9) chance. Independence in bathing, but dependence in dressing resulted in 35.4% (30.7–40.4) chance whereas the opposite resulted in 26.1% (20.7–32.3) chance. Conclusion: Simple assessment of dressing and bathing on discharge from rehabilitation enables therapeutic staff to predict prognosis for long-term independence in personal ADL. This method can be used for early identification of persons with stroke who need intensive follow-up.Implications for Rehabilitation

(In)dependence for dressing and bathing at discharge from a rehabilitation centre are significant factors in the prediction of (in)dependence in personal ADL at five years after stroke.
This predictive tool can be used for targeting inpatient stroke rehabilitation and early identification of those patients who need intensive follow-up.