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

Tuesday, July 10, 2018

Functional measures upon admission to acute inpatient rehabilitation predicts quality of life after ischemic stroke

Oh fuck, another prediction tool. Survivors don't care about prediction you blithering idiots. They want 100% recovery. GET THERE! Have you ever talked to survivors?
https://www.archives-pmr.org/article/S0003-9993(18)30430-1/fulltext

Abstract

Objective

To evaluate the association between functional measures at admission to acute inpatient rehabilitation (AIR) and HRQOL scores at 3 months after ischemic stroke.

Design

Consecutive patients with ischemic stroke admitted to AIR were consented to a prospective registry.

Setting

Large academic referral inpatient rehabilitation hospital

Participants

One-hundred thirteen patients with ischemic stroke

Interventions

NA

Main Outcome Measures

Admission Functional Independence Measure (FIM) and Berg Balance Scores (BBS) were abstracted when available. The Neuro-QOL questionnaire was used to assess 3-month HRQOL in 4 domains: upper extremity (UE), lower extremity (LE), executive functions (EF), and general concerns (GC). Associations of FIM and BBS scores with impaired HRQOL at 3 months were evaluated.

Results

One-hundred thirteen patients (mean age 70.6 ± 14.5 years; 54.0% male; 56.6% Caucasian) were included in the analysis. The median time from stroke onset to admission FIM and BBS was 6.4 (IQR 4.2-11.3) and 8.9 (IQR 5.8-14.4) days, respectively. A 5-point increase in admission FIM score decreased the likelihood of impairment in HRQOL at 3 months by 25% for GC (OR 0.75, 95% CI 0.61-0.93, p=0.01), 31% for EF (OR 0.69, 95% CI 0.56-0.85, p=0.001), 16% for UE function (OR 0.84, 95% CI 0.73-0.96, p=0.01), and 21% for LE function (OR 0.79, 95% CI 0.67-0.93 p=0.004). A 5-point increase in admission BBS decreased the likelihood of impairment in HRQOL domains at 3 months by 15% for UE function (OR 0.85, 95% CI 0.75-0.98, p=0.02) and 25% for LE function (OR 0.75, 95% CI 0.64-0.89, p=0.001).

Conclusions

Admission FIM and BBS were strongly associated with 3-month HRQOL associated across multiple domains following stroke. These findings indicate that HRQOL can be predicted earlier in a patient’s course during AIR

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