First-Year Outcomes after Stroke Rehabilitation: A Multicenter Study in Thailand

Kuptniratsaikul, Vilai; Kovindha, Apichana; Piravej, Krisna; Dajpratham, Piyapat

doi:10.1155/2013/595318

Cited by 13 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17 Our results are in contrast against those in a study by Kuptniratsaikul, et al who reported that 51.5% of patients had improved functional level while 12.8% saw a decline one year post-stroke. 18 These studies confirm the natural course of functional recovery in which significant improvement occurs within 6-12 months, with a subsequent observed tendency of the patient's functional level to stabilize or decline thereafter. It is important to emphasize that in addition to our study which enrolled stroke patients (25.4%), we also enrolled patients with SCI (53.3%) and TBI (3.5%).…”

Section: Discussionsupporting

confidence: 80%

“…Other studies reported the fact that depression is an independent indicator of poor functional status in the long-run. 18,25,26 Concerning complications, Rinkaewkan and Kuptniratsaikul conducted a retrospective study in 201 SCI patients admitted to rehabilitation wards between 2006-2010. They found an absence of comorbidity and the ability to undertake an intensive rehabilitation program to be associated with increased functional score after rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Rehabilitation Outcomes of Neurological Patients: A Multicenter Study

Srisuppaphon

Lukkanapichonchut²,

Intaratep³

et al. 2022

Siriraj Med J

Self Cite

View full text Add to dashboard Cite

Objective: To evaluate functional outcomes in patients three years after rehabilitation and to identify factors significantly associated with improvement.Materials and Methods: This prospective cohort study was carried out in nine tertiary centers to compare functional outcomes (Barthel Index; BI) at discharge with scores at three-year follow-up among various diagnoses and types of admissions. Related factors were evaluated for association with improvement in functional score.Results: Three hundred and eighteen patients (mean age: 54 years; 60% male) were included. More than half of all patients suffered from a spinal cord injury. After three years, 35% of patients were still receiving physical therapy. Only those who were admitted for intensive rehabilitation showed significant improvement after three years. One hundred and ten patients or 35.8% showed significant improvement over time. A univariate analysis showed type of diagnosis, type of admission, onset to admission interval, BI at discharge, and presence of depression and complications at follow-up to be significantly associated with improvements in functional score in the follow-up period. Using a multivariate analysis, only the type of diagnosis, low BI at discharge, and absence of depression and complications at follow-up related to functional improvement.Conclusion: One-third of patients had sustained functional improvements from rehabilitation three years after discharge. Participants admitted into intensive rehabilitation showed significant improvements in functional scores between discharge and follow-up. TBI diagnosis, low BI at discharge, absence of depression and complications at follow-up related to long-term functional improvement at the three-year mark.

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Long-Term Rehabilitation Outcomes of Neurological Patients: A Multicenter Study

Srisuppaphon

Lukkanapichonchut²,

Intaratep³

et al. 2022

Siriraj Med J

Self Cite

View full text Add to dashboard Cite

show abstract

“…Only 214 patients (65.4%) could be followed up for at least one year, whereas 8 (2.4%) died, 3 withdrew and 102 lost to follow up. Concerning the severity of participants evaluated by BI, 42.8% was mild, 17.9% moderately, 13.8% severely to very severely disabled and only 25.5% was independently [15]. The baseline characteristics of 214 patients are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Long-term morbidities in stroke survivors: a prospective multicenter study of Thai stroke rehabilitation registry

et al. 2013

Self Cite

View full text Add to dashboard Cite

BackgroundStroke-related complications are barriers to patients’ recovery leading to increasing morbidity, mortality, and health care costs, decreasing patient’s quality of life. The purpose of this study was to quantify incidence and risk factors of stroke-related complications during the first year after discharge from rehabilitation ward.MethodsA prospective observational study was conducted in nine tertiary-care rehabilitation centers. We evaluated the incidence of morbidities during the first year after stroke, including musculoskeletal pain, neuropathic pain, pneumonia, deep vein thrombosis (DVT), pressure ulcer, spasticity, shoulder subluxation, joint contracture, dysphagia, urinary incontinence, anxiety and depression. The complications at discharge and at month-12 were compared using the McNemar test. Univariate analysis and multiple logistic regression analysis by forward stepwise method were used to determine factors predicting the complications at month-12.ResultsTwo hundred and fourteen from 327 patients (65.4%) were included. The age was 62.1 ± 12.5 years, and 57.9% were male. In 76.8% of the patients at least one complication was found during the first year after stroke. Those complications were musculoskeletal pain (50.7%), shoulder subluxation (29.3%), depression (21.2%), spasticity (18.3%), joint contracture (15.7%) and urinary incontinence (14.4%). Other complications less than 5% were dysphagia (3.5%), pressure ulcer (2.6%), infection (1.5%), and neuropathic pain (3.0%). Nearly 60% of patients with complications at discharge still had the same complaints after one year. Only 7.6% were without any complication. Morbidity was significantly associated with age and type of stroke. Using multiple logistic regression analysis, age and physical complications at discharge were significant risk factors for physical and psychological morbidities after stroke respectively (OR = 2.1, 95% CI 1.2, 3.7; OR = 3.1, 95% CI 1.3, 7.1).ConclusionLong-term complications are common in stroke survivors. More than three-fourths of the patients developed at least one during the first year after rehabilitation. Strategies to prevent complications should be concerned especially on musculoskeletal pain which was the most common complaint. Physical complications at discharge period associated with psychological complications at 1 year followed up. More attention should be emphasized on patients age older than 60 years who were the major risk group for developing such complications.

show abstract

“…Previous longitudinal investigations of cerebral activity and/or cerebral regulation have been limited to two (the majority of studies) or three separate observations [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Epidemiological studies have suggested that the greatest amount of recovery occurs during the first 3 months after stroke onset [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

The Longitudinal Evolution of Cerebral Blood Flow Regulation after Acute Ischaemic Stroke

Salinet

Panerai

Robinson

2014

Cerebrovasc Dis Extra

View full text Add to dashboard Cite

Background: Acute stroke is known to impair cerebral blood flow (CBF) regulation, but the longitudinal changes of these effects have been poorly reported. The main CBF regulatory mechanisms [cerebral autoregulation (CA) and neurovascular coupling (NVC)] were assessed over 3 months after acute ischaemic stroke. Methods: Recordings of CBF velocity (CBFv), blood pressure (BP), and end-tidal CO₂ were performed during 5 min baseline and 1 min passive movement of the elbow. Stroke patients were assessed <72 h of stroke onset, and at 2 weeks, 1 and 3 months after stroke. Results: Fifteen acute stroke subjects underwent all 4 sessions and were compared to 22 control subjects. Baseline recordings revealed a significantly lower CBFv in the affected hemisphere within 72 h after stroke compared to controls (p = 0.02) and a reduction in CA index most marked at 2 weeks (p = 0.009). CBFv rise in response to passive arm movement was decreased bilaterally after stroke, particularly in the affected hemisphere (p < 0.01). Both alterations in CA and NVC returned to control levels during recovery. Conclusion: The major novel finding of this study was that both CA and NVC regulatory mechanisms deteriorated initially following stroke onset, but returned to control levels during the recovery period. These findings are relevant to guide the timing of interventions to manipulate BP and potentially for the impact of intensive rehabilitation strategies that may precipitate acute physiological perturbations but require further exploration in a larger population that better reflects the heterogeneity of stroke. Further, they will also enable the potential influence of stroke subtype to be investigated.

show abstract

First-Year Outcomes after Stroke Rehabilitation: A Multicenter Study in Thailand

Cited by 13 publications

References 26 publications

Long-Term Rehabilitation Outcomes of Neurological Patients: A Multicenter Study

Long-Term Rehabilitation Outcomes of Neurological Patients: A Multicenter Study

Long-term morbidities in stroke survivors: a prospective multicenter study of Thai stroke rehabilitation registry

The Longitudinal Evolution of Cerebral Blood Flow Regulation after Acute Ischaemic Stroke

Contact Info

Product

Resources

About