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The Relationship Between Type of Stroke and Complications and Rehabilitation Outcomes

Year 2006, Volume: 2006 Issue: 2, 76 - 83, 01.02.2006

Abstract

Objectives: We examined cases of hemiparesis with various aetiological reasons, before and after treatment in order to analyse the factors which may affect functional recovery rates, motor development and complications. Patients and Methods: Eighty-two patients (52 males; mean age 57.06±15.43; range 8-82 and 30 females; mean age 56.17±14.41; range 18-78) were retrospectively evaluated. Patient characteristics including age, gender, side of hemiparesis, type of stroke, mental condition, speech ability, the onset to rehabilitation admission interval, Brunnstrom values, the Ashworth index, the Functional Ambulation Categories (FAC), Barthel index (BI) on admission and before discharge from the hospital, complications and length of inpatient stay were recorded. Results: There were significant differences between admission and discharge Brunnstrom values, BI and FAC's in all the patients. There was a negative correlation between the onset to rehabilitation admission interval and the rate of change after treatment. A positive correlation was observed between the length of inpatient stay and the rate of change in the scores. It was determined that infections negatively affected the changes in BI and FAC's after treatment. Conclusions: Our results suggest that the functional outcome of hemiparetic patients was positively affected by rehabilitation, and that the aetiological reasons and complications did not affect the results of the treatment. Turkish Başlık: Strok Tipi ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi Anahtar Kelimeler: Serebrovasküler olay/rehabilitasyon; tedavi sonuçları Amaç: Çeşitli etyolojik nedenli hemiparezisi olan olgular tedavi öncesi ve sonrası incelenerek fonksiyonel geri dönüşüm oranları, motor gelişimleri, oluşan komplikasyonlar ve bunlar üzerinde etkisi olabilecek faktörler araştırıldı. Hastalar ve Yöntemler: Rehabilitasyona alınan 82 hasta (52 erkek; ort. yaş 57.06±15.43; dağılım 8-82 ve 30 kadın; ort. yaş 56.17±14.41; dağılım 18-78) retrospektif olarak değerlendirildi. Olguların yaş, cinsiyet, tutulan taraf, etyolojik neden, mental durum, lisan özelliği, rehabilitasyona başlayana kadar geçen süre, giriş ve taburcu öncesi Brunnstrom değerleri, Ashworth indeksleri, fonksiyonel ambulasyon evreleri (FAE), Barthel indeksleri (Bİ), takip süresince ortaya çıkan komplikasyonlar ve hastanede toplam yatış süreleri kaydedildi. Bulgular: Tüm hastaların hastaneden çıkış öncesi Brunnstrom değerleri, Bİ ve FAE'leri hastaneye yatışlarına göre anlamlı düzeyde farklıydı. Rehabilitasyona başlayana kadar geçen süre ile tedavi sonrası değişim oranı arasında negatif korelasyon vardı. Hastanede yatış süresi ile skorlardaki değişim oranının pozitif korelasyon gösterdiği görüldü. Takip sırasında gelişen enfeksiyonların Bİ ve FAE'deki değişimi olumsuz etkilediği saptandı. Sonuç: Çalışmamızın bulguları hemiparezik olguların fonksiyonel durumlarının rehabilitasyonla olumlu yönde etkilendiğini, bu değişimin etyolojik nedenlerle ilişkisiz olduğunu ve komplikasyonların tedavi sonuçlarını etkilemediğini göstermektedir.

References

  • Ryerson SD. Hemiplegia. In: Umphred DA, editor. Neurological rehabilitation. 3rd ed. St. Louis: Mosby; 1995. p. 681-721.
  • Roth EJ, Harvey RL. Rehabilitation of stroke syn- dromes. In: Braddom RL, editor. Physical medicine and rehabilitation. 1st ed. Philadelphia: W. B. Saunders Company; 1996. p. 1053-87.
  • Johnston MV, Wilkerson DL, Maney M. Evaluation of the quality and outcome of medical rehabilitation programs. In: DeLisa J, Gans BM, Currie DM, edi- tors. Rehabilitation medicine: principles and prac- tice. 2nd ed. Philadelphia: JB Lippincott; 1993. p. 240-68.
  • Adams RD, Victor M, Ropper AH. Cerebrovascular diseases. In: Adams RD, Victor M, Ropper AH, edi- tors. Principles of neurology. 7th ed. New York: Mc Graw Hill; 2001. p. 821-924.
  • Gresham GE, Stason WB. Rehabilitaion of the stroke survivor. In: Barnett HJM, Mohr JP, Stein BM, Yatsu FM, editors. Stroke: pathophysiology, diagnosis, and management. 3th ed. New York: Churchill Livingstone; 1998. 1389-401.
  • Roth EJ, Noll SF. Stroke rehabilitation. 2. Comorbidities and complications. Arch Phys Med Rehabil 1994;75(5 Spec No):S42-6.
  • Rahman KM, Sarker CB, Mohammad QD, Dhar DK, Hossain MS, Siddiqui MN, et al. Risk factors & clin- ical presentations-a study of eighty-five hospital admitted stroke cases. Mymensingh Med J 2002; 11:113-5.
  • Musicco M, Emberti L, Nappi G, Caltagirone C. Italian Multicenter Study on Outcomes of Rehabilitation of Neurological Patients. Early and long-term outcome of rehabilitation in stroke patients: the role of patient characteristics, time of initiation, and duration of interventions. Arch Phys Med Rehabil 2003;84:551-8.
  • Paolucci S, Grasso MG, Antonucci G, Bragoni M, Troisi E, Morelli D, et al. Mobility status after inpa- tient stroke rehabilitation: 1-year follow-up and prognostic factors. Arch Phys Med Rehabil 2001; 82:2-8.
  • Macciocchi SN, Diamond PT, Alves WM, Mertz T. Ischemic stroke: relation of age, lesion location, and initial neurologic deficit to functional outcome. Arch Phys Med Rehabil 1998;79:1255-7.
  • Ferrucci L, Bandinelli S, Guralnik JM, Lamponi M, Bertini C, Falchini M, et al. Recovery of functional status after stroke. A postrehabilitation follow-up study. Stroke 1993;24:200-5.
  • Laufer Y, Sivan D, Schwarzmann R, Sprecher E. Standing balance and functional recovery of patients with right and left hemiparesis in the early stages of rehabilitation. Neurorehabil Neural Repair 2003; 17:207-13.
  • Morin-Martin M, Gonzalez-Santiago R, Gil-Nunez AC, Vivancos-Mora J. Women and strokes. Hospital epidemiology in Spain. Rev Neurol 2003;37:701-5. [Abstract]
  • Tur BS, Gursel YK, Yavuzer G, Kucukdeveci A, Arasil T. Rehabilitation outcome of Turkish stroke patients: in a team approach setting. Int J Rehabil Res 2003;26:271-7.
  • Fang Y, Chen X, Li H, Lin J, Huang R, Zeng J. A study on additional early physiotherapy after stroke and factors affecting functional recovery. Clin Rehabil 2003;17:608-17.
  • Mok VC, Wong A, Lam WW, Fan YH, Tang WK, Kwok T, et al. Cognitive impairment and functional outcome after stroke associated with small vessel dis- ease. J Neurol Neurosurg Psychiatry 2004;75:560-6.
  • Heruti RJ, Lusky A, Dankner R, Ring H, Dolgopiat M, Barell V, et al. Rehabilitation outcome of elderly patients after a first stroke: effect of cognitive status at admission on the functional outcome. Arch Phys Med Rehabil 2002;83:742-9.
  • Chae J, Zorowitz RD, Johnston MV. Functional out- come of hemorrhagic and nonhemorrhagic stroke patients after in-patient rehabilitation. Am J Phys Med Rehabil 1996;75:177-82.
  • Kelly PJ, Furie KL, Shafqat S, Rallis N, Chang Y, Stein J. Functional recovery following rehabilitation after hemorrhagic and ischemic stroke. Arch Phys Med Rehabil 2003;84:968-72.
  • Lin JH, Hsieh CL, Lo SK, Hsiao SF, Huang MH. Prediction of functional outcomes in stroke inpa- tients receiving rehabilitation. J Formos Med Assoc 2003;102:695-700.
  • Xu BH, Yu RQ, Yu W, Xie B, Huang YX. Effects of early rehabilitation on activities of daily living and complications in acute stroke patients. Beijing Da Xue Xue Bao 2004;36:75-8. [Abstract]
  • Inouye M, Kishi K, Ikeda Y, Takada M, Katoh J, Iwahashi M, et al. Prediction of functional outcome after stroke rehabilitation. Am J Phys Med Rehabil 2000;79:513-8.
  • Inouye M. Predicting models of outcome stratified by age after first stroke rehabilitation in Japan. Am J Phys Med Rehabil 2001;80:586-91.
  • Pinedo S, de la Villa FM. Complications in the hemi- plegic patient in the first year after the stroke. Rev Neurol 2001;32:206-9. [Abstract]
  • Bender L, McKenna K. Hemiplegic shoulder pain: defining the problem and its management. Disabil Rehabil 2001;23:698-705.
  • Gamble GE, Barberan E, Laasch HU, Bowsher D, Tyrrell PJ, Jones AK. Poststroke shoulder pain: a prospective study of the association and risk factors in 152 patients from a consecutive cohort of 205 patients presenting with stroke. Eur J Pain 2002; 6:467-74.
  • Van Ouwenaller C, Laplace PM, Chantraine A. Painful shoulder in hemiplegia. Arch Phys Med Rehabil 1986;67:23-6.
  • McLean DE. Medical complications experienced by a cohort of stroke survivors during inpatient, ter- tiary-level stroke rehabilitation. Arch Phys Med Rehabil 2004;85:466-9.
  • Doshi VS, Say JH, Young SH, Doraisamy P. Complications in stroke patients: a study carried out at the Rehabilitation Medicine Service, Changi General Hospital. Singapore Med J 2003;44:643-52.
  • Dromerick A, Reding M. Medical and neurological complications during inpatient stroke rehabilitation. Stroke 1994;25:358-61.
  • Ratnasabapathy Y, Broad J, Baskett J, Pledger M, Marshall J, Bonita R. Shoulder pain in people with a stroke: a population-based study. Clin Rehabil 2003; 17:304-11.
  • Gillen R, Tennen H, McKee TE, Gernert-Dott P, Affleck G. Depressive symptoms and history of depression predict rehabilitation efficiency in stroke patients. Arch Phys Med Rehabil 2001;82:1645-9.
  • Cassidy E, O’Connor R, O’Keane V. Prevalence of post-stroke depression in an Irish sample and its relationship with disability and outcome following inpatient rehabilitation. Disabil Rehabil 2004;26:71-7.
  • Clark MS, Smith DS. The effects of depression and abnormal illness behaviour on outcome following rehabilitation from stroke. Clin Rehabil 1998;12:73-80.
  • Carod-Artal J, Egido JA, Gonzalez JL, Varela de Seijas E. Quality of life among stroke survivors eval- uated 1 year after stroke: experience of a stroke unit. Stroke 2000;31:2995-3000.
  • Hayee MA, Akhtar N, Haque A, Rabbani MG. Depression after stroke-analysis of 297 stroke patients. Bangladesh Med Res Counc Bull 2001; 27:96-102.
  • Gainotti G, Antonucci G, Marra C, Paolucci S. Relation between depression after stroke, antide- pressant therapy, and functional recovery. J Neurol Neurosurg Psychiatry 2001;71:258-61.

Strok Tipi ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi

Year 2006, Volume: 2006 Issue: 2, 76 - 83, 01.02.2006

Abstract

Amaç: Çeşitli etyolojik nedenli hemiparezisi olan olgular tedavi öncesi ve sonrası incelenerek fonksiyonel geri dönüşüm oranları, motor gelişimleri, oluşan komplikasyonlar ve bunlar üzerinde etkisi olabilecek faktörler araştırıldı. Hastalar ve Yöntemler: Rehabilitasyona alınan 82 hasta (52 erkek; ort. yaş 57.06±15.43; dağılım 8-82 ve 30 kadın; ort. yaş 56.17±14.41; dağılım 18-78) retrospektif olarak değerlendirildi. Olguların yaş, cinsiyet, tutulan taraf, etyolojik neden, mental durum, lisan özelliği, rehabilitasyona başlayana kadar geçen süre, giriş ve taburcu öncesi Brunnstrom değerleri, Ashworth indeksleri, fonksiyonel ambulasyon evreleri (FAE), Barthel indeksleri (Bİ), takip süresince ortaya çıkan komplikasyonlar ve hastanede toplam yatış süreleri kaydedildi. Bulgular: Tüm hastaların hastaneden çıkış öncesi Brunnstrom değerleri, Bİ ve FAE'leri hastaneye yatışlarına göre anlamlı düzeyde farklıydı. Rehabilitasyona başlayana kadar geçen süre ile tedavi sonrası değişim oranı arasında negatif korelasyon vardı. Hastanede yatış süresi ile skorlardaki değişim oranının pozitif korelasyon gösterdiği görüldü. Takip sırasında gelişen enfeksiyonların Bİ ve FAE'deki değişimi olumsuz etkilediği saptandı. Sonuç: Çalışmamızın bulguları hemiparezik olguların fonksiyonel durumlarının rehabilitasyonla olumlu yönde etkilendiğini, bu değişimin etyolojik nedenlerle ilişkisiz olduğunu ve komplikasyonların tedavi sonuçlarını etkilemediğini göstermektedir.

References

  • Ryerson SD. Hemiplegia. In: Umphred DA, editor. Neurological rehabilitation. 3rd ed. St. Louis: Mosby; 1995. p. 681-721.
  • Roth EJ, Harvey RL. Rehabilitation of stroke syn- dromes. In: Braddom RL, editor. Physical medicine and rehabilitation. 1st ed. Philadelphia: W. B. Saunders Company; 1996. p. 1053-87.
  • Johnston MV, Wilkerson DL, Maney M. Evaluation of the quality and outcome of medical rehabilitation programs. In: DeLisa J, Gans BM, Currie DM, edi- tors. Rehabilitation medicine: principles and prac- tice. 2nd ed. Philadelphia: JB Lippincott; 1993. p. 240-68.
  • Adams RD, Victor M, Ropper AH. Cerebrovascular diseases. In: Adams RD, Victor M, Ropper AH, edi- tors. Principles of neurology. 7th ed. New York: Mc Graw Hill; 2001. p. 821-924.
  • Gresham GE, Stason WB. Rehabilitaion of the stroke survivor. In: Barnett HJM, Mohr JP, Stein BM, Yatsu FM, editors. Stroke: pathophysiology, diagnosis, and management. 3th ed. New York: Churchill Livingstone; 1998. 1389-401.
  • Roth EJ, Noll SF. Stroke rehabilitation. 2. Comorbidities and complications. Arch Phys Med Rehabil 1994;75(5 Spec No):S42-6.
  • Rahman KM, Sarker CB, Mohammad QD, Dhar DK, Hossain MS, Siddiqui MN, et al. Risk factors & clin- ical presentations-a study of eighty-five hospital admitted stroke cases. Mymensingh Med J 2002; 11:113-5.
  • Musicco M, Emberti L, Nappi G, Caltagirone C. Italian Multicenter Study on Outcomes of Rehabilitation of Neurological Patients. Early and long-term outcome of rehabilitation in stroke patients: the role of patient characteristics, time of initiation, and duration of interventions. Arch Phys Med Rehabil 2003;84:551-8.
  • Paolucci S, Grasso MG, Antonucci G, Bragoni M, Troisi E, Morelli D, et al. Mobility status after inpa- tient stroke rehabilitation: 1-year follow-up and prognostic factors. Arch Phys Med Rehabil 2001; 82:2-8.
  • Macciocchi SN, Diamond PT, Alves WM, Mertz T. Ischemic stroke: relation of age, lesion location, and initial neurologic deficit to functional outcome. Arch Phys Med Rehabil 1998;79:1255-7.
  • Ferrucci L, Bandinelli S, Guralnik JM, Lamponi M, Bertini C, Falchini M, et al. Recovery of functional status after stroke. A postrehabilitation follow-up study. Stroke 1993;24:200-5.
  • Laufer Y, Sivan D, Schwarzmann R, Sprecher E. Standing balance and functional recovery of patients with right and left hemiparesis in the early stages of rehabilitation. Neurorehabil Neural Repair 2003; 17:207-13.
  • Morin-Martin M, Gonzalez-Santiago R, Gil-Nunez AC, Vivancos-Mora J. Women and strokes. Hospital epidemiology in Spain. Rev Neurol 2003;37:701-5. [Abstract]
  • Tur BS, Gursel YK, Yavuzer G, Kucukdeveci A, Arasil T. Rehabilitation outcome of Turkish stroke patients: in a team approach setting. Int J Rehabil Res 2003;26:271-7.
  • Fang Y, Chen X, Li H, Lin J, Huang R, Zeng J. A study on additional early physiotherapy after stroke and factors affecting functional recovery. Clin Rehabil 2003;17:608-17.
  • Mok VC, Wong A, Lam WW, Fan YH, Tang WK, Kwok T, et al. Cognitive impairment and functional outcome after stroke associated with small vessel dis- ease. J Neurol Neurosurg Psychiatry 2004;75:560-6.
  • Heruti RJ, Lusky A, Dankner R, Ring H, Dolgopiat M, Barell V, et al. Rehabilitation outcome of elderly patients after a first stroke: effect of cognitive status at admission on the functional outcome. Arch Phys Med Rehabil 2002;83:742-9.
  • Chae J, Zorowitz RD, Johnston MV. Functional out- come of hemorrhagic and nonhemorrhagic stroke patients after in-patient rehabilitation. Am J Phys Med Rehabil 1996;75:177-82.
  • Kelly PJ, Furie KL, Shafqat S, Rallis N, Chang Y, Stein J. Functional recovery following rehabilitation after hemorrhagic and ischemic stroke. Arch Phys Med Rehabil 2003;84:968-72.
  • Lin JH, Hsieh CL, Lo SK, Hsiao SF, Huang MH. Prediction of functional outcomes in stroke inpa- tients receiving rehabilitation. J Formos Med Assoc 2003;102:695-700.
  • Xu BH, Yu RQ, Yu W, Xie B, Huang YX. Effects of early rehabilitation on activities of daily living and complications in acute stroke patients. Beijing Da Xue Xue Bao 2004;36:75-8. [Abstract]
  • Inouye M, Kishi K, Ikeda Y, Takada M, Katoh J, Iwahashi M, et al. Prediction of functional outcome after stroke rehabilitation. Am J Phys Med Rehabil 2000;79:513-8.
  • Inouye M. Predicting models of outcome stratified by age after first stroke rehabilitation in Japan. Am J Phys Med Rehabil 2001;80:586-91.
  • Pinedo S, de la Villa FM. Complications in the hemi- plegic patient in the first year after the stroke. Rev Neurol 2001;32:206-9. [Abstract]
  • Bender L, McKenna K. Hemiplegic shoulder pain: defining the problem and its management. Disabil Rehabil 2001;23:698-705.
  • Gamble GE, Barberan E, Laasch HU, Bowsher D, Tyrrell PJ, Jones AK. Poststroke shoulder pain: a prospective study of the association and risk factors in 152 patients from a consecutive cohort of 205 patients presenting with stroke. Eur J Pain 2002; 6:467-74.
  • Van Ouwenaller C, Laplace PM, Chantraine A. Painful shoulder in hemiplegia. Arch Phys Med Rehabil 1986;67:23-6.
  • McLean DE. Medical complications experienced by a cohort of stroke survivors during inpatient, ter- tiary-level stroke rehabilitation. Arch Phys Med Rehabil 2004;85:466-9.
  • Doshi VS, Say JH, Young SH, Doraisamy P. Complications in stroke patients: a study carried out at the Rehabilitation Medicine Service, Changi General Hospital. Singapore Med J 2003;44:643-52.
  • Dromerick A, Reding M. Medical and neurological complications during inpatient stroke rehabilitation. Stroke 1994;25:358-61.
  • Ratnasabapathy Y, Broad J, Baskett J, Pledger M, Marshall J, Bonita R. Shoulder pain in people with a stroke: a population-based study. Clin Rehabil 2003; 17:304-11.
  • Gillen R, Tennen H, McKee TE, Gernert-Dott P, Affleck G. Depressive symptoms and history of depression predict rehabilitation efficiency in stroke patients. Arch Phys Med Rehabil 2001;82:1645-9.
  • Cassidy E, O’Connor R, O’Keane V. Prevalence of post-stroke depression in an Irish sample and its relationship with disability and outcome following inpatient rehabilitation. Disabil Rehabil 2004;26:71-7.
  • Clark MS, Smith DS. The effects of depression and abnormal illness behaviour on outcome following rehabilitation from stroke. Clin Rehabil 1998;12:73-80.
  • Carod-Artal J, Egido JA, Gonzalez JL, Varela de Seijas E. Quality of life among stroke survivors eval- uated 1 year after stroke: experience of a stroke unit. Stroke 2000;31:2995-3000.
  • Hayee MA, Akhtar N, Haque A, Rabbani MG. Depression after stroke-analysis of 297 stroke patients. Bangladesh Med Res Counc Bull 2001; 27:96-102.
  • Gainotti G, Antonucci G, Marra C, Paolucci S. Relation between depression after stroke, antide- pressant therapy, and functional recovery. J Neurol Neurosurg Psychiatry 2001;71:258-61.
There are 37 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ferda Özdemir This is me

Derya Demirbağ This is me

Sadiye Murat This is me

Siranuş Kokino This is me

Publication Date February 1, 2006
Published in Issue Year 2006 Volume: 2006 Issue: 2

Cite

APA Özdemir, F., Demirbağ, D., Murat, S., Kokino, S. (2006). Strok Tipi ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi. Balkan Medical Journal, 2006(2), 76-83.
AMA Özdemir F, Demirbağ D, Murat S, Kokino S. Strok Tipi ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi. Balkan Medical Journal. February 2006;2006(2):76-83.
Chicago Özdemir, Ferda, Derya Demirbağ, Sadiye Murat, and Siranuş Kokino. “Strok Tipi Ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi”. Balkan Medical Journal 2006, no. 2 (February 2006): 76-83.
EndNote Özdemir F, Demirbağ D, Murat S, Kokino S (February 1, 2006) Strok Tipi ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi. Balkan Medical Journal 2006 2 76–83.
IEEE F. Özdemir, D. Demirbağ, S. Murat, and S. Kokino, “Strok Tipi ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi”, Balkan Medical Journal, vol. 2006, no. 2, pp. 76–83, 2006.
ISNAD Özdemir, Ferda et al. “Strok Tipi Ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi”. Balkan Medical Journal 2006/2 (February 2006), 76-83.
JAMA Özdemir F, Demirbağ D, Murat S, Kokino S. Strok Tipi ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi. Balkan Medical Journal. 2006;2006:76–83.
MLA Özdemir, Ferda et al. “Strok Tipi Ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi”. Balkan Medical Journal, vol. 2006, no. 2, 2006, pp. 76-83.
Vancouver Özdemir F, Demirbağ D, Murat S, Kokino S. Strok Tipi ve Komplikasyonların Rehabilitasyon Sonuçlarıyla İlişkisi. Balkan Medical Journal. 2006;2006(2):76-83.