Effectiveness of an Inpatient Multidisciplinary Rehabilitation Program for People With Parkinson Disease

2008 ◽  
Vol 88 (7) ◽  
pp. 812-819 ◽  
Author(s):  
Terry Ellis ◽  
Douglas I Katz ◽  
Daniel K White ◽  
T Joy DePiero ◽  
Anna D Hohler ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Speech Therapy ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Change Score ◽  
Rehabilitation Program ◽  
Primary Diagnosis ◽  
Outpatient Setting ◽  
Total Change

Background and PurposeIn the outpatient setting, it can be difficult to effectively manage the complex medical and rehabilitation needs of people with Parkinson disease (PD). A multidisciplinary approach in the inpatient rehabilitation environment may be a viable alternative. The purposes of this study were: (1) to investigate the effectiveness of an inpatient rehabilitation program for people with a primary diagnosis of PD, (2) to determine whether gains made were clinically meaningful, and (3) to identify predictors of rehabilitation outcome.SubjectsSixty-eight subjects with a diagnosis of PD were admitted to an inpatient rehabilitation hospital with a multidisciplinary movement disorders program.MethodsSubjects participated in a rehabilitation program consisting of a combination of physical therapy, occupational therapy, and speech therapy for a total of 3 hours per day, 5 to 7 days per week, in addition to pharmacological adjustments based on data collected daily. A pretest-posttest design was implemented. The differences between admission and discharge scores on the Functional Independence Measure (FIM) (total, motor, and cognitive scores), Timed “Up & Go” Test, 2-Minute Walk Test, and Finger Tapping Test were analyzed.ResultsAn analysis of data obtained for the 68 subjects admitted with a diagnosis of PD revealed significant improvements across all outcome measures from admission to discharge. Subjects with PD whose medications were not adjusted during their admission (rehabilitation only) (n=10) showed significant improvements in FIM total, motor, and cognitive scores. Improvements exceeded the minimal clinically important difference in 71% of the subjects. Prior level of function at admission accounted for 20% of the variance in the FIM total change score.Discussion and ConclusionThe results suggest that subjects with a diagnosis of PD as a primary condition benefited from an inpatient rehabilitation program designed to improve functional status.

scholarly journals Factors Related to Greater Functional Recovery after Suffering a Stroke

2021 ◽  
Vol 11 (6) ◽  
pp. 802
Author(s):  
María Vázquez-Guimaraens ◽  
José L. Caamaño-Ponte ◽  
Teresa Seoane-Pillado ◽  
Javier Cudeiro
Keyword(s):  
Functional Status ◽  
Hospital Discharge ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Primary Diagnosis ◽  
Rehabilitation Service ◽  
Bivariate Analysis ◽  
Linear Regression Models ◽  
Functional Assessments

Background: In a stroke, the importance of initial functional status is fundamental for prognosis. The aim of the current study was to investigate functional status, assessed by the Functional Independence Measure (FIM) scale, and possible predictors of functional outcome at discharge from inpatient rehabilitation. Methods: This is a retrospective study that was carried out at the Physical Medicine and Rehabilitation Service in A Coruña (Spain). A total of 365 consecutive patients with primary diagnosis of stroke were enrolled. The functional assessments of all patients were performed through the FIM. A descriptive and a bivariate analysis of the variables included in the study was made and a succession of linear regression models was used to determine which variables were associated with the total FIM at discharge. Results: Prior to having the stroke, 76.7% were totally independent in activities of daily living. The FIM scale score was 52.5 ± 25.5 points at admission and 83.4 ± 26.3 at hospital discharge. The multivariate analysis showed that FIM scores on admission were the most important predictors of FIM outcomes. Conclusions: Our study indicates that the degree of independence prior to admission after suffering a stroke is the factor that will determine the functionality of patients at hospital discharge.

Determining Stroke Rehabilitation Inpatients' Level of Nursing Care

2001 ◽  
Vol 10 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Jan Coleman Gross ◽  
Stacey W. Goodrich ◽  
Mary E. Kain ◽  
Elizabeth A. Faulkner
Keyword(s):  
Nursing Care ◽  
Stroke Rehabilitation ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Two Factors ◽  
Staffing Needs ◽  
Care Index ◽  
Strong Inverse Relationship

The purpose of this study was to evaluate the feasibility of using the Functional Independence Measure (FIM) to predict staffing needs of stroke patients in an acute inpatient rehabilitation program. The Patient Care Index (PCI) was concurrently administered with the FIM on all stroke admissions to a stroke rehabilitation unit over a 3-month period. One hundred fourteen patients 18 years of age or older admitted to the unit with a medical diagnosis of stroke were included in the sample. Total FIM score had a strong inverse relationship to the level of care indicated by the PCI at Days 1, 5, 7, 10, 15, and 20 of rehabilitation (rs = —.76 to —.87). Total FIM score and the need for staff supervision for safety were the two factors predictive of the level of nursing care. The FIM has potential to guide nurse-staffing decisions.

scholarly journals The Association Between Sarcopenia and Functional Improvement in Older and Younger Patients Who Completed Inpatient Rehabilitation: A Prospective Cohort Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Irina Churilov ◽  
Leonid Churilov ◽  
Kim Brock ◽  
David Murphy ◽  
Richard J. MacIsaac ◽  
...  
Keyword(s):  
Cohort Study ◽  
Goal Attainment ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Functional Improvement ◽  
Goal Attainment Scaling ◽  
Standard Error Estimation ◽  
Measure Change

Objective: To investigate the association between sarcopenia and functional improvement in patients older and younger than 65 years upon completion of an inpatient rehabilitation program.Design: Prospective cohort study.Participants: Adult consecutive patients who completed the inpatient rehabilitation program at a metropolitan tertiary referral hospital general inpatient rehabilitation unit.Methods: Sarcopenia status was determined using the European Working Group on Sarcopenia in Older People 2 algorithm, using muscle mass measured by BioImpedance Analysis and grip strength. Progress in rehabilitation was measured using change in the Functional Independence Measure and Goal Attainment Scaling score. To investigate the age group by sarcopenia status interaction we used quantile regression models with bootstrapped standard error estimation for functional improvement and linear regression model with robust standard error estimation for GAS score.Results: 257 participants [128 (50%) male, median age 63 years (IQR: 52–72)], 33(13%) with sarcopenia, completed inpatient rehabilitation [median length of stay 16 days (IQR: 11–27.5)]. Participants' median Functional Independence Measure change was 24 (IQR 15–33.5) and mean total Goal Attainment Scaling score was 57.6 (SD 10.2). Adjusting for admission Functional Independence Measure score, the median difference in Functional Independence Measure change between participants with and without sarcopenia was: −4.3 (95% CI: −10.6, 1.9); p = 0.17 in participants 65 years and younger, and 4.6 (95% CI: 1.0, 8.2); p = 0.01 in participants older than 65; age-by-sarcopenia interaction p = 0.02.Conclusions: Unlike younger people, older people with sarcopenia have greater functional improvement in inpatient rehabilitation than those without sarcopenia.

scholarly journals Locomotor Training Within an Inpatient Rehabilitation Program After Pediatric Incomplete Spinal Cord Injury

2007 ◽  
Vol 87 (9) ◽  
pp. 1224-1232 ◽  
Author(s):  
Laura A Prosser
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pediatric Population ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Locomotor Training ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury

Background and Purpose: The outcomes of intense locomotor training after incomplete spinal cord injury (SCI) have been described in adults with acute and chronic injuries and with various levels of ambulatory function. This case report describes a comprehensive inpatient rehabilitation program with a locomotor training component in a child with a severe incomplete SCI.Case Description: A 5-year-old girl injured at C4 participated in locomotor training for 5 months during inpatient rehabilitation.Outcomes: The patient's Functional Independence Measure for Children II (WeeFIM II) mobility score increased from 5/35 to 21/35. Her Walking Index for Spinal Cord Injury II (WISCI II) score improved from 0 to 12. The patient returned to walking in the community with assistive devices.Discussion: It is feasible to include an intense locomotor training program in the clinical rehabilitation setting for a child with a severe SCI, and the outcomes were consistent with results in adults. Further investigation with experimental designs and more participants will determine the extent to which this intervention benefits the pediatric population with SCI.

Abstract P104: Impact Of Orthostatic Hypotension In Inpatient Rehabilitation

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Luis E. Okamoto ◽  
Purnima Sharma ◽  
Lauren Massey ◽  
Italo Biaggioni ◽  
Jeff Johns
Keyword(s):  
Spinal Cord ◽  
Orthostatic Hypotension ◽  
Significant Proportion ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Admission Diagnosis ◽  
Neurological Conditions ◽  
The Difference ◽  
Spinal Cord Dysfunction

Inpatient rehabilitation is crucial in the management of patients after injuries, surgery, or those with debilitating or neurological conditions. Orthostatic hypotension (OH) is commonly associated with these conditions, and therefore, the inability to stand and participate in rehabilitation therapy can negatively impact their recovery. To test this hypothesis, we study a cohort of 8352 patients who underwent rehabilitation at Vanderbilt Stallworth Rehabilitation Hospital between 2014-2019 to assess the prevalence of OH and its impact on the length of stay (LOS), functional independence measure (FIM) change (discharge FIM-admission FIM), and FIM efficiency (FIM change/LOS), compared to patients without OH admitted during the same period. We found that the prevalence of OH was 3.8% (n = 314; 60±18 yrs; 227 men). OH was commonly associated with patients admitted for neurological conditions (29%, n = 91), spinal cord dysfunction (22%, n = 71), orthopedic disorders (13%, n = 13), and stroke (10%, n = 33). On admission, patients with OH had a longer predicted LOS compared to those without OH (18±6 vs. 16±5 days, respectively, p = 0.001), reflecting greater medical complexity. Moreover, the actual LOS at discharge was significantly longer in OH patients compared to those without OH (19±12 vs. 13±9 days; p = 0.001) as was the difference between actual-predicted LOC (1±11 vs. 2±8; p = 0.001). The change in FIM was similar in both patients with and without OH (30±26 vs. 33±20, respectively; p = 0.52) but FIM efficiency was lower in OH patients (2±2.2 vs. 3±2.2 without OH; p = 0.001). OH prolonged LOS regardless of the admission diagnosis (stroke, other neurological conditions, spinal cord dysfunction and orthopedic disorders). In conclusion, OH is present in a significant proportion of patients undergoing acute rehabilitation and adversely impacts the recovery of these patients as measured by lower FIM efficacy and a prolonged rehabilitation period to achieve the same functional gain as patients without OH.

scholarly journals Length of Stay in In-Patient Rehabilitation after Stroke in Qatar

2008 ◽  
Vol 8 ◽  
pp. 547-555
Author(s):  
Loganathan Venkatachalm ◽  
Ana Bobinac Georgievski ◽  
Wafaa Al Yazeedi ◽  
Rajvir Singh ◽  
Hilda Uribazo Garrido
Keyword(s):  
Length Of Stay ◽  
Hemorrhagic Stroke ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Significant Negative Correlation ◽  
Multivariate Regression Analysis ◽  
Functional Independence ◽  
Medical Rehabilitation ◽  
Rehabilitation Unit ◽  
Disability Scale

The objective of this study was to analyze the factors predicting length of stay in a stroke patient rehabilitation unit at Hamad Medical Corporation (HMC) in Qatar. The medical rehabilitation data of 100 stroke patients discharged from a 15-bed inpatient rehabilitation unit (IPRU) were collected retrospectively from medical records during the period from September 2004 to April 2007. A questionnaire was developed, and variables included in the study were age of the patient, length of stay in acute care (LOSa), length of stay in rehabilitation (LOSr), functional independence measure on admission and discharge (FIMa and FIMd), modified disability scale, and modified mobility scale. Patients were grouped by impairments defined by cause as ischemic or hemorrhagic stroke, and right or left body side deficit. A significant negative correlation was observed between LOSr and FIMa (r= −0.44,p= 0.00), and positive correlation between LOSr and LOSa (r= 0.37,p= 0.00). There was no correlation between LOSr and FIMd (r= −0.03,p= 0.76). We observed that low admission FIMa and FIMd were related to extended LOS in both acute and IPRU. Multivariate regression analysis was performed by taking age, LOSa, cause of hemorrhage or ischemia, and FIMa as independent variables, and LOSr as dependent variable. The model could explain only 26% variation for LOSr. This study supports the hypothesis of an association between LOSr, LOSa, and FIMa. Further research is needed to confirm the results of this and other similar studies.

scholarly journals Depressive Symptoms in Individuals after Stroke in a Home-Based Rehabilitation Setting

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Julianne Vermeer ◽  
Amanda McIntyre ◽  
Shannon Janzen ◽  
Danielle Rice ◽  
Laura Allen ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Poststroke Depression ◽  
Rehabilitation Team ◽  
Care Access ◽  
Home Based ◽  
Patient Health ◽  
The Impact

Poststroke depression has been shown to affect rehabilitation progress. This study evaluated patients after stroke who actively participated in a home-based rehabilitation program to determine variables that correlated with depressive symptoms in this population. A retrospective review of patients who were provided rehabilitation by Community Stroke Rehabilitation Team clinicians between January 1, 2009, and September 30, 2015, was completed. Logistic regression analysis was conducted to determine which demographic and outcome variables (Functional Independence Measure [FIM™] and Reintegration to Normal Living Index [RNLI]) were independently associated with depressive symptoms, as defined by Patient Health Questionnaire (PHQ-9) scores. 889 patients (53.2% male, mean age = 69.8 years) were included. Based on PHQ-9 scores, 89.7% of patients presented with no or mild depressive symptoms (PHQ-9 < 10) and 10.3% were considered to have moderate to severe depressive symptoms (PHQ-9 ≥ 10). The regression demonstrated that referral from outpatient, community care access centre, or community settings (OR = 1.89, p=0.04), low RNLI scores (OR = 0.92; p=0.001), and younger age (OR = 0.96; p<0.001) predicted patients having moderate to severe depressive symptoms. Given the impact of poststroke depression on rehabilitation, clinicians should consider the potential impact of referral source, community reintegration, and age when monitoring and treating depressive symptoms.

scholarly journals Interdisciplinary Therapy for patients with dementia

2014 ◽  
Vol 8 (3) ◽  
pp. 285-290
Author(s):  
Maysa Luchesi Cera ◽  
Daniela Cristina Carvalho de Abreu ◽  
Rosângela de Abreu Venancio Tamanini ◽  
Amanda Carla Arnaut ◽  
Patrícia Pupin Mandrá ◽  
...  
Keyword(s):  
Intervention Program ◽  
Functional Performance ◽  
Functional Dependence ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Clinical Dementia Rating ◽  
Interdisciplinary Intervention

Patients with dementia require rehabilitation involving several health professionals, where interdisciplinary care can further enhance the routine of patients and their families.OBJECTIVE:To compare the functional performance of elderly with dementia before and after an interdisciplinary intervention program provided by a healthcare service of medium complexity.METHODS: Three cases with clinically-confirmed dementia enrolled on an interdisciplinary rehabilitation program were reported. The following instruments were applied: Mini Mental-State Exam, Clinical Dementia Rating, Geriatric Depression Scale, Lawton & Brody Index, and the Functional Independence Measure for adults (FIM). The therapeutic strategies were individualized and designed based on patient performance on the FIM, according to the criteria of the Classification of Functionality, Disability and Health, implemented at the house of therapy of the Center for Integrated Rehabilitation together with provision of guidance.RESULTS: A reduction in functional dependence was observed after intervention, evidenced by less supervision needed to carry out Activities of Daily Living. Conclusion: The three patients benefited from the interdisciplinary intervention.

scholarly journals Physiotherapy and Rehabilitation in a Child with Joubert Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Özge İpek ◽  
Özge Akyolcu ◽  
Banu Bayar
Keyword(s):  
Developmental Delay ◽  
Genetic Disorder ◽  
Clinical Signs ◽  
Functional Independence Measure ◽  
Female Child ◽  
Joubert Syndrome ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Reverse Direction ◽  
Motor Functioning

Objective. Joubert syndrome (JS) is a rare autosomal recessive genetic disorder characterized by brain malformation, hypotonia, breathing abnormalities, ataxia, oculomotor apraxia, and developmental delay. The purpose of this study was to report the efficiency of the physiotherapy and rehabilitation program in a child with JS. Materials and Methods. Our case is a 19-month-old female child with mild clinical signs of JS. The pretreatment and posttreatment motor functioning level of the case was evaluated through the Gross Motor Function Measure (GMFM), whereas the independence level was evaluated through the Pediatric Functional Independence Measure (WeeFIM). The case was included in the rehabilitation program by the physiotherapist for one hour for five days a week throughout the period of 13 months in accordance with the neurodevelopmental treatment principles. Results. The case was able to turn around from the supine position to the reverse direction by oneself, and she was able to rise on her forearms facedown and was able to sit, crawl, and walk independently. The GMFM score was 210, whereas WeeFIM score was 65. Discussion. In the direction of those findings, in Joubert Syndrome, physiotherapy and rehabilitation can be effective in coping with the symptoms causing developmental delay.

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