The Brain Recovery Core

Lang, Catherine E.; Bland, Marghuretta D.; Connor, Lisa Tabor; Fucetola, Robert; Whitson, Michelle; Edmiaston, Jeff; Karr, Clayton; Sturmoski, Audra; Baty, Jack; Corbetta, Maurizio

doi:10.1097/npt.0b013e318235dc07

Cited by 35 publications

(34 citation statements)

References 69 publications

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“…For patients who can walk, assessment of gait speed with the 10-m walk test can help determine functional ambulatory ability. 276,277 Risk of fall with ambulation is important for counseling patient and family on safety.…”

Section: Assessing Overall Rehabilitation Needsmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

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2,187

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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Section: Assessing Overall Rehabilitation Needsmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

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2,187

840

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“…10, 11 All patients in the database have a primary diagnosis of stroke (ischemic, hemorrhagic, or transient ischemic attack), and have provided informed consent to have his or her stroke rehabilitation data stored and used for research. The Washington University Human Research Protection Office approved the database and studies using de-identified data.…”

Section: Methodsmentioning

confidence: 99%

Quantifying Change During Outpatient Stroke Rehabilitation: A Retrospective Regression Analysis

Lohse

Bland²,

Lang³

2016

Archives of Physical Medicine and Rehabilitation

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Objective To examine change and individual trajectories for balance, upper extremity motor capacity, and mobility in people post-stroke during the time they received outpatient therapies. Design Retrospective analyses of an observational cohort using hierarchical linear modeling. Setting Outpatient rehabilitation Participants 366 persons post stroke Interventions Usual outpatient physical and occupational therapy Main Outcomes Berg Balance Scale (BBS), Action Research Arm Test (ARAT), and walking speed were used to assess the 3 domains. Initial scores at the start of outpatient therapy (intercepts), rate of change during outpatient therapy (slopes), and the covariance between slopes and intercepts were modeled as random-effects. Additional variables modeled as fixed effects were: Duration (months of outpatient therapy), Time (days post-stroke), Age (years), and Inpatient status (if the patient went to an inpatient rehabilitation facility (IRF)). Results A patient with average Age and Time started at 37 points on the BBS with a change of +1.8 points per month, at 35 points on the ARAT with a change of +2.0 points per month, and with a walking speed of 0.59 m/s with a change of +0.09 m/s per month. When controlling for other variables, patients started with lower scores on the BBS and ARAT or had slower walking speeds at admission if they started outpatient therapy later than average or went to an IRF. Conclusions Patients generally improved over the course of outpatient therapy, but there was considerable variability in individual trajectories. Average rates of change across all three domains were small.

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“…20, 21 All participants admitted to Barnes-Jewish Hospital and The Rehabilitation Institute of St. Louis undergo standardized assessments by professional discipline PT, OT, and SLP. This battery was developed with both therapist and administrative input to meet the needs of participants and clinicians at each facility across the rehabilitation continuum, and it is considered the minimum assessment requirement for all persons with stroke.…”

Section: Methodsmentioning

confidence: 99%

“…The battery encompasses the domains of motor (PT, OT), cognition (OT, SLP) and language (SLP) (see Appendix 1 for a brief summary), with approximately nine measures in the PT battery, 14 in the OT battery and 16 in the SLP battery. 20 Each measure is not required at every setting. As reflects the clinical needs, the measurements begin as more impairment-based for the acute setting while the outpatient assessments include participation measures.…”

Section: Methodsmentioning

confidence: 99%

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Clinician Adherence to a Standardized Assessment Battery Across Settings and Disciplines in a Poststroke Rehabilitation Population

Bland

Sturmoski

Whitson

et al. 2013

Archives of Physical Medicine and Rehabilitation

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Objective 1) To examine clinician adherence to a standardized assessment battery across settings (acute hospital, IRF, outpatient facility), professional disciplines (PT, OT, SLP), and time of assessment (admission, discharge/monthly), and 2) evaluate how specific implementation events affected adherence. Design Retrospective cohort study Setting Acute hospital, IRF, outpatient facility with approximately 118 clinicians (PT, OT, SLP). Participants 2194 participants with stroke who were admitted to at least one of the above settings. All persons with stroke undergo standardized clinical assessments. Interventions N/A Main Outcome Measure Adherence to Brain Recovery Core assessment battery across settings, professional disciplines and time. Visual inspections of 17 months of time-series data were conducted to see if the events (e.g. staff meetings) increased adherence ≥ 5% and if so, how long the increase lasted. Results Median adherence ranged from 0.52 to 0.88 across all settings and professional disciplines. Both the acute hospital and IRF had higher adherence than the outpatient setting (p ≤ .001) with PT having the highest adherence across all three disciplines (p < .004). Of the 25 events conducted across the 17 month period to improve adherence, 10 (40%) resulted in a ≥ 5% increase in adherence the following month, with 6 services (60%) maintaining their increased level of adherence for at least one additional month. Conclusion Actual adherence to a standardized assessment battery in clinical practice varied across settings, disciplines and time. Specific events increased adherence 40% of the time with gains maintained for greater than a month in 60%.

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The Brain Recovery Core

Cited by 35 publications

References 69 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Quantifying Change During Outpatient Stroke Rehabilitation: A Retrospective Regression Analysis

Clinician Adherence to a Standardized Assessment Battery Across Settings and Disciplines in a Poststroke Rehabilitation Population

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