Stroke rehabilitation patients, practice, and outcomes: is earlier and more aggressive therapy better?
Publication/Presentation Date
12-1-2005
Abstract
UNLABELLED: Horn SD, DeJong G, Smout RJ, Gassaway J, James R, Conroy B. Stroke rehabilitation patients, practice, and outcomes: is earlier and more aggressive therapy better?
OBJECTIVE: To examine associations of patient characteristics, rehabilitation therapies, neurotropic medications, nutritional support, and timing of initiation of rehabilitation with functional outcomes and discharge destination for inpatient stroke rehabilitation patients.
DESIGN: Prospective observational cohort study.
SETTING: Five U.S. inpatient rehabilitation facilities.
PARTICIPANTS: Post-stroke rehabilitation patients (N=830; age, >18 y) with moderate or severe strokes, from the Post-Stroke Rehabilitation Outcomes Project database.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Discharge total, motor, and cognitive FIM scores and discharge destination.
RESULTS: Controlling for patient differences, various activities and interventions were associated with better outcomes including earlier initiation of rehabilitation, more time spent per day in higher-level rehabilitation activities such as gait, upper-extremity control, and problem solving, use of newer psychiatric medications, and enteral feeding. Several findings part with conventional practice, such as starting gait training in the first 3 hours of physical therapy, even for low-level patients, was associated with better outcomes.
CONCLUSIONS: Specific therapy activities and interventions are associated with better outcomes. Earlier rehabilitation admission, higher-level activities early in the rehabilitation process, tube feeding, and newer medications are associated with better stroke rehabilitation outcomes.
Volume
86
Issue
12 Suppl 2
First Page
101
Last Page
101
ISSN
0003-9993
Published In/Presented At
Horn, S. D., DeJong, G., Smout, R. J., Gassaway, J., James, R., & Conroy, B. (2005). Stroke rehabilitation patients, practice, and outcomes: is earlier and more aggressive therapy better?. Archives of physical medicine and rehabilitation, 86(12 Suppl 2), S101–S114. https://doi.org/10.1016/j.apmr.2005.09.016
Disciplines
Medicine and Health Sciences
PubMedID
16373145
Department(s)
Department of Medicine
Document Type
Article
