Predicting length of stay, functional outcome, and aftercare in the rehabilitation of stroke patients. The dominant role of higher-order cognition.

Galski, Thomas; Bruno, Richard L.; Zorowitz, Richard D.; Walker, John E.

doi:10.1161/01.str.24.12.1794

Cited by 153 publications

(81 citation statements)

References 35 publications

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“…While previous studies have demonstrated that a cognitive deterioration within the first three months post-stroke is a good predictor of an adverse functional outcome (Galski et al, 1993;Tatemichi et al, 1994;Mok et al, 2004;Nys et al, 2005) and post-stroke dementia (Lin et al, 2003), it is not known whether a detailed evaluation of specific cognitive functions in the early phase of stroke can give valid information about domain-specific cognitive functioning in the long term. Moreover, the prevalence of cognitive recovery and the cognitive abilities most likely to recover have not been adequately investigated, and it is unclear which clinical factors influence cognitive recovery after stroke.…”

Section: Introductionmentioning

confidence: 99%

Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases

Nys

Zandvoort

Kort

et al. 2005

J. Inter. Neuropsych. Soc.

141

125

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The objective of this study is to examine the prognosis of acute cognitive disorders post-stroke, and to evaluate which clinical factors predict domain-specific cognitive recovery. We followed the course of cognitive functioning in 111 stroke patients and 77 healthy controls by administering two neuropsychological examinations with a 6 to 10 month interval (mean interval, 7.5 6 1.3 months). The baseline examination was administered within three weeks post-stroke (mean interval, 7.9 6 4.2 days). To examine determinants of domain-specific cognitive recovery, we recorded vascular risk factors, clinical variables, and lesion characteristics. Recovery in visual perception0construction (83%) and visual memory (78%) was the most common. An acute cognitive disorder predicted a long-term disorder in the same domain (all p , .05), except for visual perception0construction. Factors associated with poor cognitive recovery were age (all p , .01), preexistent verbal ability (all p , .005), lesion locations involving the temporal (all p , .05), frontal ( p , .05) and occipital lobe (all p , .05), lesion volume ( p Յ .001), and diabetes mellitus ( p , .01). An early neuropsychological examination provides valuable information on long-term cognitive performance. The prognosis of higher-level visual disorders is the most favorable. Cognitive recovery is associated with age, preexistent ability, lesion volume, lesion location, and diabetes mellitus. (JINS, 2005, 11, 795-806.)

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Section: Introductionmentioning

confidence: 99%

Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases

Nys

Zandvoort

Kort

et al. 2005

J. Inter. Neuropsych. Soc.

141

125

View full text Add to dashboard Cite

show abstract

“…Fizioterapeuti i medicinske sestre s odjela interne klinike i odjela rehabilitacije veći-nom smatraju (56,8 %) kako rade u interdisciplinarnom timu, uz pokazatelj znatno bolje otvorene komunikacije na odjelu rehabilitacije 18 . Timska suradnja interdisciplinarnog tipa u rehabilitaciji primjere dobre kliničke prakse prikazuje kod neuromuskularnih bolesti 6 , ortopedije 19 , ortotike 20 i protetike 3 , fizikalne medicine i rehabiltacije 21 i cerebrovaskularnih bolesti 22 , no budući da u većini dostupne literature odnosi između članova tima nisu točno specificirani 13 , a imaju elemente interdisciplinarnosti, možemo smatrati da postoje dokazi o prihvaćenosti pristupa i u drugim područjima.…”

Section: Izazov U Struci I Organizaciji Rehabilitacijske Skrbiunclassified

Interdisciplinarni timski rad – izazov u suvremenoj rehabilitaciji

Lončarić¹,

Kováč²,

Đurašin³

et al. 2016

JAHS

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“…8,9 Moreover, most of these studies have used global cognitive screening measures in the early phase of stroke, although these measures demonstrate poor sensitivity in detecting cognitive impairment in stroke patients.…”

Section: Abstract-objectivementioning

confidence: 99%

“…[1][2][3][4][5] While cognitive disorders are among the most frequent and devastating early consequences of stroke, 6,7 few studies have examined the prognostic importance of these acute disorders. 8,9 Moreover, most of these studies have used global cognitive screening measures in the early phase of stroke, although these measures demonstrate poor sensitivity in detecting cognitive impairment in stroke patients. 10 Also, these global measures do not allow evaluation of cognitive performance in specific domains.…”

mentioning

confidence: 99%

Ischemic optic neuropathy and carotid dissection

Koch¹,

Lorenzo²,

Rabinstein³

et al. 2005

Neurology

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Abstract-Objective:To evaluate the prognostic value of domain-specific cognitive abilities in acute stroke with respect to long-term cognitive and functional outcome in addition to neurologic and demographic predictors. Methods: The authors evaluated 168 patients within the first 3 weeks after first-ever stroke. The prevalence of neuropsychological impairment was calculated vs 75 matched healthy controls. The authors also recorded demographic data, vascular risk factors, lesion characteristics, and clinical factors at admission. Independent predictor variables associated with long-term cognitive impairment (assessed with a follow-up neuropsychological examination) and functional impairment (assessed with the modified Barthel Index and the Frenchay Activities Index) were identified with stepwise multiple logistic regression. Areas under receiver operator characteristic curves were used to compare the predictive value of three models, i.e., a standard medical model, a purely cognitive model, and a model consisting of both medical and cognitive predictors. Results: Thirty-one percent of patients showed long-term cognitive impairment. Basic and instrumental ADL disturbances remained present in 19% and 24% of patients. Domain-specific cognitive functioning predicted cognitive and functional outcome better than any other variable. Moreover, the prediction of instrumental ADL functioning improved when cognitive predictors were added to the standard medical model (p Ͻ 0.05). Impairments in abstract reasoning and executive functioning were independent predictors of long-term cognitive impairment. Inattention and perceptual disorders were more important in predicting long-term functional impairment. Conclusion: Domain-specific cognitive abilities in the early phase of stroke are excellent independent predictors of long-term cognitive and functional outcome. NEUROLOGY 2005;64:821-827 Several factors have been identified as predictors for long-term disability and adverse outcome, such as initial stroke severity and lesion characteristics, functional status at admission with respect to activities of daily life (ADL), vascular risk factors, and demographic factors.1-5 While cognitive disorders are among the most frequent and devastating early consequences of stroke, 6,7 few studies have examined the prognostic importance of these acute disorders. 8,9 Moreover, most of these studies have used global cognitive screening measures in the early phase of stroke, although these measures demonstrate poor sensitivity in detecting cognitive impairment in stroke patients.10 Also, these global measures do not allow evaluation of cognitive performance in specific domains. Other studies on poststroke cognitive impairment have focused on the prognostic value of isolated impairments such as unilateral neglect, 11,12 anosognosia, 13 aphasia, 14 or apraxia. 15 A detailed neuropsychological evaluation covering the whole cognitive spectrum in acute stroke has not been reported, probably because of uncertainty about the feasibility and reliabi...

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Predicting length of stay, functional outcome, and aftercare in the rehabilitation of stroke patients. The dominant role of higher-order cognition.

Cited by 153 publications

References 35 publications

Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases

Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases

Interdisciplinarni timski rad – izazov u suvremenoj rehabilitaciji

Ischemic optic neuropathy and carotid dissection

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