Citations
To evaluate effects of caregiver's education program on their satisfaction, as well as patient functional recovery, performed in addition to daily conventional rehabilitation treatment.
Three hundred eleven subjects diagnosed with first-onset stroke and transferred to the Department of Physical Medicine and Rehabilitation of Inha University Hospital were surveyed. In 2015, caregivers attended an education program for acute and subacute stroke patients. Patients who received an additional rehabilitation therapy were assigned to the experimental group (n=81), whereas the control group (n=100) consisted of transfer cases in 2014 with only conventional treatment. The experimental group was classified by severity using the Korean version of the National Institutes of Health Stroke Scale (K-NIHSS), which was administered to all 181 subjects, in addition to, the Korean version of the Mini Mental Status Examination (K-MMSE), a Modified Barthel Index (K-MBI), and the Berg Balance Scale (K-BBS). Caregiver satisfaction and burden before and after education programs were assessed using the Canadian Occupational Performance Measure (COPM), as well as family burden and caregiver burnout scales.
No significant intergroup difference was observed between initial K-NIHSS, K-MMSE, K-BBS, K-MBI scores, and times from admission to transfer. Those with moderate or severe strokes under the experimental condition showed a more significant improvement than the control group as determined by the K-NIHSS and K-BBS, as well as tendential K-MMSE and K-MBI score increases. Satisfaction was significantly greater for family members and formal caregivers of patients with strokes of moderate severity in the experimental group.
The caregiver's education program for stroke subjects had a positive outcome on patients' functional improvement and caregiver satisfaction. The authors believe that the additional rehabilitation therapy with the education program aids patients to achieve functional improvements for an optimal return to social life.
Citations
To evaluate the influence of atrial fibrillation (Af) on the clinical characteristics and rehabilitation outcomes of patients with cerebral infarction.
We evaluated 87 of 101 consecutive patients with cerebral infarction admitted to the department of physical medicine and rehabilitation during their rehabilitation period. The patients were divided into two groups, Af and non-Af groups. We estimated characteristics of patient demographic features, disease duration, length of hospital stay, other comorbidities and risk factors for stroke, and functional status at admission and at discharge and compared those in patients with and without Af. Functional Independence Measure (FIM), the Modified Barthel Index (MBI), and the PULSES profile (PULSES) were used to evaluate functional status.
The number in the Af group was 20 (22.9%) and that of the non-Af group was 67 (77.1%). Demographic features, other comorbidities, motor function, cognitive function, neurological scales, and brain lesions did not differ significantly between the groups. The incidence of coronary artery disease and valvular heart disease were significantly correlated with the incidence of Af in multivariate analysis. Based on FIM, MBI, and PULSES scores, functional improvement in the Af group after rehabilitation was significantly less than that of the non-Af group.
Af was shown to be associated with a markedly negative result in rehabilitation in patients with cerebral infarction. Thus, early recognition and proper treatment of Af may help patients achieve more effective rehabilitation.
Citations
The incidence of traumatic brain injury (TBI) has increased with the advanced technology of society. A careful evaluation of associated problems, initial severity, and complications is important for the acute management and rehabilitation of patients with TBI. To predict the rehabilitation potentials of patients with TBI, we have retrospectively investigated the causes, types of injury, associated problems, and complications in 186 patients and also assessed the rehabilitation outcomes by measuring the functional gains according to the types of brain injury and the initial severities evaluated by the Glasgow coma scale in 82 patients. The functional gains were measured by differences of the Mini-mental status examination, PULSES profile, and Barthel index of pre- and post-rehabilitation states. The incidence of TBI was highest in the 3rd decade men and the most common cause was a traffic accident (120 cases, 64.5%). The types of brain injury were a diffuse axonal injury, 87 cases (46.8%); epidural hematoma, 21 cases (11.3 %); subarachnoid hemorrhage, 25 cases (13.4%); subdural hematoma, 28 cases (15.1%); and intracerebral hematoma, 25 cases (12.9%). Common associated problems were fractures and injuries of nervous system. The 7th cranial nerve and the peroneal nerve were the most common injuries for cranial and peripheral nerves, respectively. Common complications were pulmonary and skin disorders. Total hospital stay and the duration for rehabilitation were not significantly different by the types of injury. Functional gain tended to be higher in the intracerebral hematoma compared to the other types of brain injury. The functional gain was statistically higher in patients with initial severity of moderate degree according to the Glasgow coma scale. In conclusion the moderate traumatic brain injured patients seem to have a higher potential for the good functional outcome.
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