Deans' stroke musings: Factors Influencing Receipt of Early Rehabilitation following Stroke

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.

Friday, August 9, 2013

Factors Influencing Receipt of Early Rehabilitation following Stroke

A completely worthless study. No mention of looking at any type of objective damage diagnosis.
Is everyone stupid?
http://www.archives-pmr.org/article/S0003-9993%2813%2900587-X/abstract

Abstract

Objective

To identify patient level characteristics associated with rehabilitation during the acute post-stroke phase as effective rehabilitation following stroke can minimize disability and enhance recovery. Initiation of rehabilitation depends on many clinical and non-clinical factors.

Design

Retrospective cohort. Generalized estimating equations modeled the likelihood of rehabilitation during the index hospitalization to account for patient clusters.

Setting

All VHA facilities

Participants

Total sample included 9,681 Veterans diagnosed with new stroke discharged from Veterans Health Administration (VHA) facilities between October 1, 2006 and September 30, 2008.

Interventions

Not applicable

Main Outcome measures

Receipt of rehabilitation services

Results

Seventy-three percent of the cohort received some type of rehabilitation. Average age was 68.7 years and 97.4% were male. After adjustment, stroke patients with cerebral arteries occlusion were most likely to receive rehabilitation compared to other stroke types (p<0.0001). Patients with pre-stroke conditions of metastatic cancer (OR=0.68, p<0.01) and psychosis (OR=0.90, p=0.04) were less likely to have rehabilitation while those with hypertension (OR=1.26, p<0.01) and other neurological disorders (OR=1.29, p<0.0001) were more likely. Compared to patients admitted from home, patients transferred from a non-VA hospital (OR=1.40, p<0.01) were more likely to receive rehabilitation, while patients admitted from extended care (OR=0.59, p<0.0001) were less likely. Married veterans were less likely to receive rehabilitation services (OR=0.87, p<0.01) than unmarried veterans.

Conclusions

Within the VHA, initiating rehabilitation in the acute phase post-stroke appears to be influenced by patient clinical characteristics and living circumstances.