Functional Outcome of Multidisciplinary Rehabilitation in Chronic Stroke

Miyai, Ichiro; Suzuki, Tsuyoshi; Kii, Katsumasa; Kang, Jin Kyung; Kajiura, Ichiro

doi:10.1177/154596839801200303

Cited by 12 publications

(13 citation statements)

References 9 publications

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“…All were transferred to our hospital for inpatient multidisciplinary rehabilitation based on neurodevelopmental technique. 18,19 The patients did not reach an independent level in ambulation and activities of daily living after medical treatment and less intensive physical therapy for 2 to 3 months in acute hospitals. Each patient underwent NIRS recording before and after 2 months of inpatient rehabilitation.…”

Section: Methodsmentioning

confidence: 95%

Longitudinal Optical Imaging Study for Locomotor Recovery After Stroke

Miyai

Yagura

Hatakenaka

et al. 2003

Stroke

214

160

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Section: Methodsmentioning

confidence: 95%

Longitudinal Optical Imaging Study for Locomotor Recovery After Stroke

Miyai

Yagura

Hatakenaka

et al. 2003

Stroke

214

160

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“…13,17 On admission and discharge, functional outcome was evaluated with the use of standardized measures of documented reliability: the Functional Independence Measure (FIM) for disability 18 and the Stroke Impairment Assessment Set (SIAS) for neurological impairment. 19,20 We also analyzed motor and cognition subscores of FIM.…”

Section: Methodsmentioning

confidence: 99%

“…On average, 106 days (Ϯ6 SEM) after the acute stroke, the patients who were persistently nonambulatory began this study and their rehabilitation. 13 Patients with severe medical complications (nϭ17) participated in abbreviated programs, but they were excluded because they were not available for weekly assessments. Patients with isolated motor or visual deficits (nϭ14) were excluded in favor of patients with more severe deficits in motor, vision, and sensory processing.…”

mentioning

confidence: 99%

Improved Functional Outcome in Patients With Hemorrhagic Stroke in Putamen and Thalamus Compared With Those With Stroke Restricted to the Putamen or Thalamus

Miyai

Suzuki

Kang

et al. 2000

Stroke

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Background and Purpose-We analyzed the effect of late intensive inpatient rehabilitation on the functional outcome of patients with subcortical hemorrhagic stroke. Methods-Patients who were nonambulatory with hemorrhagic stroke in the internal capsule and putamen (nϭ55), the thalamus (nϭ24), or all 3 regions (nϭ15) underwent intensive inpatient rehabilitation. Patients with surgical intervention or an episode of ventricular hemorrhage were excluded. Lesion location was evaluated by MRI 4 months after the ictus. Results-Demographic data, initial disability, and impairment measures were comparable in the 3 groups. Functional outcome demonstrated significant differences in mobility subscores (PϽ0.05) of the Functional Independence Measure such that patients with injury in the 3 regions were more likely to ambulate independently than were patients in the other groups. Lesion location data demonstrated that the ventral anterior nucleus of the thalamus was always spared; the ventral posterior (lateral and medial) nucleus was always damaged, and the ventral lateral nucleus was frequently damaged. Putaminal damage always included the postcommissural area. In addition, the entire posterior half limb of the internal capsule was always damaged. Conclusions-Subcortical lesions to multiple structures in the basal ganglia-thalamocortical motor circuits permitted enhanced motor recovery. Lesion location predicted the level of independent ambulation and the rate of recovery in patients with stroke who were nonambulatory before neurorehabilitation therapy. Key Words: cerebral hemorrhage Ⅲ putamen Ⅲ rehabilitation Ⅲ thalamus O utcome and functional imaging studies have demonstrated that recovery mechanisms proceed at different rates [1][2][3][4] and as a function of lesion size and location. [5][6][7] Furthermore, they have enhanced an understanding of the pathogenesis of the late consequences of stroke by suggesting candidate brain regions that may underlie recovery. For example, recent studies have demonstrated that middle cerebral artery stroke in which damage extends to the premotor cortex (PMC) has been associated with poor functional outcome. 8,9 Clearly, damage that includes the parallel outputs from the primary motor area, PMC, and supplementary motor area (SMA) magnifies the functional disability and diminishes the response to rehabilitation efforts. 10 -12 These structure-function relationships prompted us to test whether location of damage restricted to the subcortical structures (putamen [Pt] and thalamus [Th]) differentially affected functional outcome. Neuroimaging information was obtained during a chronic stable phase after hematoma and edema resolution. Subjects and MethodsWe screened 132 consecutive patients with subcortical hemorrhage and without a previous history of cerebrovascular disease. The conventional treatment required patients to remain in the local acute care hospitals and receive some physical therapy for 2 to 3 months. Patients who remained persistently dependent and nonambulatory were transferred ...

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“…Concerns exist that patients with more severe conditions and a lower initial functional status tend to have a delayed admission to an IRH [6]. It also has been reported that patients who experience chronic strokes can benefit from care at an IRH [8‐10]. In addition to time to IRH admission, patient clinical and demographic characteristics, initial functional status, and medical and rehabilitation management all affect a patient's recovery from stroke [1,2,11].…”

Section: Introductionmentioning

confidence: 99%