http://link.springer.com/article/10.1007/s12975-013-0293-y#page-2
Abstract
Apathy and hypersomnia
occur after stroke and, by definition, reduce participation in
rehabilitation, but their effect on outcome from acute rehabilitation is
not known. We performed a retrospective review of 213 patients admitted
to a stroke-specialized acute rehabilitation unit in the United States.
All patients had ischemic or hemorrhagic stroke, and no dementia or
dependence on others pre-stroke. We diagnosed apathy and hypersomnia
using standardized documentation by treating therapists. We used
multiple regression analysis to control for overall impairment
(combination of strength, cognitive and sensory measures), age, time
since stroke, and stroke type (ischemic or hemorrhagic). Forty-four
(21 %) of the patients had persistent apathy, and 12 (5.6 %) had
persistent hypersomnia. Both groups were more impaired in cognition,
sustained attention, and more likely to be treated for depression.
Patients with apathy were 2.4 times more likely to go to a nursing home,
and had discharge FIM scores 12 points below the mean. Patients with
hypersomnia were ten times more likely to go to a nursing home, and had
discharge FIM scores 16 points below the mean. These findings indicate
that studies to prospectively define these clinical factors and
potential confounds using standardized tools are indicated, and if
confirmed, justify studies to identify these patients early and develop
targeted interventions.
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