Gender differences in post‐stroke functional outcome at discharge from an intensive rehabilitation hospital

Poggesi, Anna; Insalata, Greta; Papi, Gioele; Rinnoci, Valentina; Donnini, Ida; Martini, Monica; Falsini, C.; Hakiki, Bahia; Romoli, Annamaria; Barbato, Carmen; Polcaro, Paola; Casamorata, Francesca; Macchi, Claudio; Cecchi, Francesca; Salvadori, Emilia

doi:10.1111/ene.14769

Cited by 15 publications

(6 citation statements)

References 16 publications

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“…After a stroke, sex was associated with lower post-stroke physical activity [32] and different improvements in physical function following home-based rehabilitation among home-dwelling patients [33]. So far, even though differences in functional outcomes after inpatient rehabilitation have been found between sexes [34,35], no evidence is available on high-intensity gait rehabilitation after suffering a stroke. A randomised trial comparing robot-assisted gait training (RAGT) versus conventional training in a population of neurologic patients, including stroke survivors, showed that walking recovery in the RAGT group was significantly improved among females compared with males [36].…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

et al. 2021

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Background and Objectives: Robot-assisted gait training (RAGT) could be a rehabilitation option for patients after experiencing a stroke. This study aims to determine the sex-related response to robot-assisted gait training in a cohort of subacute stroke patients considering mixed results previously reported. Materials and Methods: In this study, 236 participants (145 males, 91 females) were admitted to a rehabilitation facility after experiencing a stroke and performed RAGT within a multidisciplinary rehabilitation program. Functional Independence Measure (FIM) and Functional Ambulatory Category (FAC) were assessed at admission and discharge to determine sex-related outcomes. Results: At the baseline, no significant difference among sexes was observed. At the end of rehabilitation, both males and females exhibited significant improvements in FIM (71% of males and 80% of females reaching the MCID cut-off value) and FAC (∆score: men 1.9 ± 1.0; women 2.1 ± 1.1). A more remarkable improvement was observed in women of the whole population during the study, but statistical significance was not reached. When analysing the FAC variations with respect to the total number of RAGT sessions, a more significant improvement was observed in women than men (p = 0.025). Conclusion: In conclusion, among subacute stroke patients, benefits were observed following RAGT during a multidisciplinary rehabilitation program in both sexes. A greater significant recovery for women with an ischemic stroke or concerning the number of sessions attended was also highlighted. The use of gait robotics for female patients may favour a selective functional recovery after stroke.

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Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

et al. 2021

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“…In reference to the level of independence, a significant negative correlation is also shown with the age variable, where an increase in age determines a worse general functional capacity and a lower level of independence. Poggesi et al [48] found in their results that age may also be an influential factor in the patient's functional outcomes after a stroke, although it appeared to be associated with sex, so that men's functional recovery decreased with increasing age while older women continued to improve regardless of the initial deficit. Previous studies also found that age, gender and type of stroke predict long-term functional outcome after discharge [21,38].…”

Section: Discussionmentioning

confidence: 96%

A Cross-Sectional Study: Determining Factors of Functional Independence and Quality of Life of Patients One Month after Having Suffered a Stroke

González‐Santos

Rodríguez-Fernández

Pardo-Hernández

et al. 2023

IJERPH

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(1) Background: loss of quality of life (QoL) and functional independence are two of the most common consequences of suffering a stroke. The main objective of this research is to study which factors are the greatest determinants of functional capacity and QoL a month after suffering a stroke so that they can be considered in early interventions. (2) Methods: a cross-sectional study was conducted which sample consisted of 81 people who had previously suffered a stroke. The study population was recruited at the time of discharge from the Neurology Service and Stroke Unit of the hospitals of Burgos and Córdoba, Spain, through a consecutive sampling. Data were collected one month after participants experienced a stroke, and the main study variables were quality of life, measured with the Stroke-Specific Quality of Life Measure (NEWSQOL), and functional independence, measured with the Functional Independence Measure-Functional Assessment Measure (FIM-FAM). (3) Results: the factors associated with a worse QoL and functional capacity one month after having suffered a stroke were living in a different dwelling than the usual flat or house (p < 0.05), a worse cognitive capacity (p < 0.001) and a worse functional capacity of the affected upper limb (p < 0.001). A higher age was related to a worse functional capacity one month after suffering a stroke (p = 0.048). (4) Conclusions: the type of dwelling, age, cognitive ability and functional capacity of the affected upper limb are determining aspects in functional independence and QoL during the first weeks after a stroke.

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“…König et al [ 32 ] claimed that age, together with the National Institutes of Health Stroke Scale score, is sufficient to correctly predict survival and functional recovery after 3 months. However, the predicting value of age on stroke rehabilitation continues to be controversial [ 33 ]. Our path analysis demonstrated that younger patients are, independently of an initial impairment, associated with better recovery, as measured by FM-UE and Barthel index measurements post-intervention.…”

Section: Discussionmentioning

confidence: 99%

The Route of Motor Recovery in Stroke Patients Driven by Exoskeleton-Robot-Assisted Therapy: A Path-Analysis

et al. 2021

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Background: Exoskeleton-robot-assisted therapy is known to positively affect the recovery of arm functions in stroke patients. However, there is a lack of evidence regarding which variables might favor a better outcome and how this can be modulated by other factors. Methods: In this within-subject study, we evaluated the efficacy of a robot-assisted rehabilitation system in the recovery of upper limb functions. We performed a path analysis using a structural equation modeling approach in a large sample of 102 stroke patients (age 63.6 ± 13.1 years; 61% men) in the post-acute phase. They underwent 7 weeks of bilateral arm training assisted by an exoskeleton robot combined with a conventional treatment (consisting of simple physical activity together with occupational therapy). The upper extremity section of the Fugl–Meyer (FM-UE) scale at admission was used as a predictor of outcome, whereas age, gender, side of the lesion, days from the event, pain scale, duration of treatment, and number of sessions as mediators. Results: FM-UE at admission was a direct predictor of outcome, as measured by the motricity index of the contralateral upper limb and trunk control test, without any other mediating factors. Age, gender, days from the event, side of lesion, and pain scales were independently associated with outcomes. Conclusions: To the best of our knowledge, this is the first study assessing the relationship between clinical variables and outcomes induced by robot-assisted rehabilitation with a path-analysis model. We define a new route for motor recovery of stroke patients driven by exoskeleton-robot-assisted therapy, highlighting the role of FM-UE at admission as a useful predictor of outcome, although other variables need to be considered in the time-course of disease.

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Gender differences in post‐stroke functional outcome at discharge from an intensive rehabilitation hospital

Cited by 15 publications

References 16 publications

Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

A Cross-Sectional Study: Determining Factors of Functional Independence and Quality of Life of Patients One Month after Having Suffered a Stroke

The Route of Motor Recovery in Stroke Patients Driven by Exoskeleton-Robot-Assisted Therapy: A Path-Analysis

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