Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Saturday, January 14, 2017

Multivariable prediction of return to work at 6-month follow-up in patients with mild to moderate acute stroke

My speech therapist was trying to get me to work on work-related stuff during the first couple months, talking to my manager about getting assignments. I don't think she ever thought about or understood the 6 month medical leave I was on. I wasn't going to jeopardize that leave by trying to retrieve my computer. Wouldn't have done any good anyway since the hospital back then did not have wifi. I was extremely confident that returning to work would not be a problem. My ex was concerned because all she heard was cases where survivors had gone back to work, not been able to handle it and were fired. My job was only going to be held open for 6 months so I had to return in 6 months. My NIHSS score was probably a 6.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J74953&phrase=no&rec=132276&article_source=Rehab&international=0&international_language=&international_location=
Archives of Physical Medicine and Rehabilitation , Volume 97(12) , Pgs. 2061-2067.

NARIC Accession Number: J74953.  What's this?
ISSN: 0003-9993.
Author(s): Van Patten, Ryan; Merz, Zachary C.; Mulhauser, Kyler; Fucetola, Robert.
Publication Year: 2016.
Number of Pages: 7.
Abstract: Study investigated predictors of return to work (RTW) in in patients with mild-to-moderate stroke. Data were obtained from the Brain Recovery Core, a collaborative interinstitutional endeavor among an academic medical center, an acute care hospital, and a rehabilitation center. Excluded cases included those with nontraditional and/or nonpaid job status, no National Institute of Health Stroke Scale (NIHSS) score, and an NIHSS score >16. The final sample included 244 patients with stroke. The outcome variable was a yes/no query pertaining to whether the patient self-reported that he or she had returned to work at 6 months after the stroke. The primary analysis was a simultaneous logistic regression model, predicting RTW from sociodemographic variables, stroke severity (NIHSS), and physical and neurocognitive measures. Before the addition of any predictor variables, the accuracy of the model projecting that all patients returned to work was 57.3 to 58.2 percent. Adding predictor variables to the logistic regression model increased accuracy by approximately 18 percent. Greater independence in the sit-to-stand movement predicted improved RTW rates (odds ratio [OR] 1.8), whereas nonwhite race (OR 2.52) and greater impairment on the NIHSS (OR .88) predicted attenuated RTW rates. Findings suggest that valid measures of stroke severity and a clinician-rated sit-to-stand movement have utility in the acute prediction of later RTW in patients with mild-to-moderate stroke. Given the complexity of the RTW construct and the acute measurement of these variables, the findings can be used to inform clinical decisions and appropriately tailor rehabilitative strategies that improve quality of life for stroke survivors.
Descriptor Terms: CLIENT CHARACTERISTICS, EMPLOYMENT REENTRY, OUTCOMES, PREDICTION, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Van Patten, Ryan, Merz, Zachary C., Mulhauser, Kyler, Fucetola, Robert. (2016). Multivariable prediction of return to work at 6-month follow-up in patients with mild to moderate acute stroke.  Archives of Physical Medicine and Rehabilitation , 97(12), Pgs. 2061-2067. Retrieved 1/14/2017, from REHABDATA database.

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