The functional assessment for control of trunk (FACT): An assessment tool for trunk function in stroke patients

2020 ◽  
pp. 1-8
Author(s):  
Keisuke Sato ◽  
Keisuke Maeda ◽  
Takahiro Ogawa ◽  
Akio Shimizu ◽  
Shinsuke Nagami ◽  
...  

BACKGROUND: The Functional Assessment for Control of Trunk (FACT) was developed to evaluate trunk function after stroke. However, only a few studies used FACT to show functional outcome. OBJECTIVE: This study aimed to validate the FACT predictive ability for functional outcome following stroke and create an English version of the FACT. METHODS: This retrospective, observational study was conducted with patients aged≥65 years with stroke. Patients were divided into two groups according to the median FACT score at admission: trunk impairment or high trunk function group. Multiple regression analysis was performed for Functional Independence Measure (FIM) gain and FIM efficiency to examine the relationship between trunk function assessed by FACT at admission and functional prognosis. RESULTS: 105 participants (mean age, 80.2±7.6, 57.1%were men) were included. Of these, 48 (45.7%) and 57 (54.3%) were categorized to the trunk impairment group and high trunk function group, respectively. FACT score at admission was associated with FIM gain (coefficient = 0.875, P = 0.001) and FIM efficiency (coefficient = 0.015, P = 0.016) after adjusting for confounders. CONCLUSIONS: Trunk impairment at admission assessed by FACT could predict functional prognosis. The English version of FACT was created and further demonstrated the validity of FACT.

2019 ◽  
Vol 99 (7) ◽  
pp. 904-914
Author(s):  
Wouter J Harmsen ◽  
Ladbon Khajeh ◽  
Gerard M Ribbers ◽  
Majanka H Heijenbrok-Kal ◽  
Emiel Sneekes ◽  
...  

Abstract Background Physical inactivity, sedentary lifestyles, and low functional outcome are thought to impact the level of physical fitness in patients with aneurysmal subarachnoid hemorrhage (a-SAH). However, changes in fitness over time and associated factors have not been studied in a-SAH. Objective The objective was to evaluate the level of physical fitness in the first year after a-SAH and explore longitudinal relations with physical activity, sedentary behavior, and functional outcome. Additionally, we evaluated whether physical fitness could be predicted by disease-related characteristics (ie, severity of a-SAH, location of the aneurysm, treatment procedure, pituitary dysfunction, and complications). Design This was a prospective 1-year follow-up study. Methods Fifty-two participants performed exercise testing at 6 and 12 months after a-SAH. Cardiopulmonary exercise testing and isokinetic dynamometry were applied to determine the peak oxygen uptake $({\rm{\dot{V}}}{{\rm{o}}_{2{\rm{peak}}}})$ and the peak torque of the knee extensors (PText) and flexors (PTflex). In addition, physical activity and sedentary behavior were evaluated by accelerometer-based activity monitoring. The functional outcome was assessed by the Functional Independence Measure and Functional Assessment Measure. Disease-related characteristics were collected at hospital intake. Results At both 6 and 12 months, all fitness parameters were lower compared with predicted values (ranging from 18% to 28%). Physical activity is related to both ${\rm{\dot{V}}}{{\rm{o}}_{{\rm{2peak}}}}$ and PTflex. The Functional Independence Measure and Functional Assessment Measure scores was related to PText and PTflex. Further, participants who underwent surgical clipping had lower ${\rm{\dot{V}}}{{\rm{o}}_{{\rm{2peak}}}}$ and PTflex. Limitations Longitudinal observations cannot confirm causality. Conclusions Levels of physical fitness remain low over the first year after a-SAH. Participants who were physically more active had higher levels of physical fitness, whereas participants with impaired functional outcome or who were treated with surgical clipping were at risk of low physical fitness. Exercise interventions are warranted and should focus on the promotion of physical activity and target patients with impaired functional outcome or those who have been treated with surgical clipping.


2020 ◽  
Vol 34 (3) ◽  
pp. 247-259
Author(s):  
Zhenxiang Han ◽  
Lili Qi ◽  
Qinfeng Xu ◽  
Mingzhu Xu ◽  
Lei Cai ◽  
...  

Background and purpose. The identification of a genetic role for cognitive outcome could influence the design of individualized treatment in poststroke rehabilitation. The aim of this study is to determine whether brain-derived neurotrophic factor ( BDNF) Val66Met polymorphism is independently associated with poststroke functional outcome. Methods. A total of 775 stroke patients with genomic data were identified from the Partners HealthCare Biobank, which contains a large number of genotypes from Biobank’s consented patients. Of 775 stroke patients who met the inclusion/exclusion criteria, 86 were enrolled. Functional outcomes were assessed using the Functional Independence Measure scores at the time of admission and discharge. Logistic and linear regression models adjusted for covariate variables, including age, sex, and medical conditions, were used to evaluate the association between BDNF Val66Met and functional outcome. Results. We detected a significant correlation between Met alleles and lower cognitive function at discharge in both ischemic and hemorrhagic stroke patients. Genotyping findings confirmed that BDNF Met allele frequency was higher in contrast to Val/Val allele frequency in lower cognitive functional recovery. Furthermore, after adjusting for covariate variables, BDNF Met alleles were found to be associated with lower cognitive outcome [ P = .003; odds ratio (OR) = 5.95 (1.81-19.52)] and recovery [ P = .006; OR = 3.16 (1.4-7.15)], especially with lower problem solving, expression, and social recovery in all stroke patients. Conclusions. Met allele carriers exhibited impaired poststroke cognitive function. The BDNF genotype may be a useful predictor of cognitive function in inpatient poststroke rehabilitation.


2020 ◽  
Vol 17 (4) ◽  
pp. 437-445
Author(s):  
Irene Ciancarelli ◽  
Giovanni Morone ◽  
Marco Iosa ◽  
Stefano Paolucci ◽  
Loris Pignolo ◽  
...  

Background: Limited studies concern the influence of obesity-induced dysregulation of adipokines in functional recovery after stroke neurorehabilitation. Objective: To investigate the relationship between serum leptin, resistin, and adiponectin and functional recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential significance as prognostic markers of rehabilitation outcomes was also verified. Methods: Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale (mRS), and Functional Independence Measure (FIM). Results: Compared to controls, higher leptin and resistin values and lower adiponectin values were observed in stroke patients before neurorehabilitation and no correlations were found between adipokines and clinical outcome measures. Neurorehabilitation was associated with improved scores of BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and resistin together increased adiponectin were detected in stroke patients, while leptin decreased but not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score, and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified leptin as prognostic factor for BI, mRS, and FIM. Conclusions: Our data show the effectiveness of neurorehabilitation in modulating adipokines levels and suggest that leptin could assume the significance of biomarker of functional recovery.


Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 365
Author(s):  
Cecilia Estrada-Barranco ◽  
Roberto Cano-de-la-Cuerda ◽  
Vanesa Abuín-Porras ◽  
Francisco Molina-Rueda

(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months).


1995 ◽  
Vol 74 (6) ◽  
pp. 432-438 ◽  
Author(s):  
Tetsuya Tsuji ◽  
Shigeru Sonoda ◽  
Kazuhisa Domen ◽  
Eiichi Saitoh ◽  
Meigen Liu ◽  
...  

Author(s):  
L. Shuranova ◽  
J. Vacková

The Functional Independence Measure and Functional Assessment Measure (FIM + FAM) is an effective, efficient, and objective tool for tracking changes in the motor, cognitive, and psychosocial functions of patients over the entire treatment and rehabilitation period. It is estimated that in the Czech Republic (CR), stroke is the third most common cause of death and the most common cause of adult disability. To develop faster, better, and more cost‑effective stroke treatments and reduce or mitigate functional losses and restrictive situations, it is very important that patients be objectively evaluated, relative to their functional abilities, as soon as possible after a stroke. A critical part of stroke treatment is to calculate the length of in‑hospital treatment and estimate the length of the rehabilitation period after the stroke. Contemporary methods for evaluating and analyzing a patient’s condition are based on test results and evidence.The FIM offers a more sensitive rating scale compared to BI due to the presence of cognitive items and is used worldwide for assessment during the acute stage of the disease. Thus, it is an efficient instrument for setting therapy goals and evaluating the effects of rehabilitation. Not only can it assist the therapist in clinical decision making, but it also functions as a tool for evaluating rehabilitation outcomes. Based on this test, short‑term and long‑term rehabilitation plans can be determined. At the end of the rehabilitation process, assessing the patient’s functional condition helps to predict the specific long‑term rehabilitation services the patient will need as they return to society and regain their quality of life.


1996 ◽  
Vol 12 (3) ◽  
pp. 161-171 ◽  
Author(s):  
Lucie Brosseau ◽  
Louise Potvin ◽  
Pierre Philippe ◽  
Yves-Louis Boulanger ◽  
Elisabeth Dutil

Sign in / Sign up

Export Citation Format

Share Document