Functional independence: A comparison of the changes during neurorehabilitation between patients with non-traumatic subarachnoid hemorrhage and intracerebral hemorrhage or acute ischemic stroke.

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@article{5b27829177dc4e4aaa68f81e16fe1bda,
title = "Functional independence: A comparison of the changes during neurorehabilitation between patients with non-traumatic subarachnoid hemorrhage and intracerebral hemorrhage or acute ischemic stroke.",
keywords = "Functional independence following neurorehabilitation",
author = "Stabel, {Henriette Holm} and Pedersen, {Asger Roer} and Johnsen, {Søren Paaske} and Nielsen, {Jørgen Feldbæk}",
year = "2017",
month = "3",
volume = "98",
pages = "759--65",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B.Saunders Co.",
number = "4",

}

RIS

TY - JOUR

T1 - Functional independence: A comparison of the changes during neurorehabilitation between patients with non-traumatic subarachnoid hemorrhage and intracerebral hemorrhage or acute ischemic stroke.

AU - Stabel,Henriette Holm

AU - Pedersen,Asger Roer

AU - Johnsen,Søren Paaske

AU - Nielsen,Jørgen Feldbæk

PY - 2017/3/24

Y1 - 2017/3/24

N2 - ObjectiveTo compare the changes in functional independence measured by the FIM after specialized neurorehabilitation between patients with nontraumatic subarachnoid hemorrhage (SAH) and patients with intracerebral hemorrhage (ICH) or acute ischemic stroke (AIS).DesignHistorical cohort study comparing changes in functional independence between patients with nontraumatic SAH and those with ICH/AIS, using FIM scores from a local database and clinical information from the Danish National Patient Registry.SettingPostacute specialized inpatient neurorehabilitation.ParticipantsParticipants (N=660) comprised patients with a first-time nontraumatic SAH (n=212) and age-matched patients with a first-time ICH/AIS (n=448).InterventionsNot applicable.Main Outcome MeasuresCrude and adjusted comparisons of FIM (total and item by item) measured at baseline and at discharge.ResultsPatients with nontraumatic SAH were admitted with a lower functional level compared with patients with ICH/AIS (median total FIM score, 25 [interquartile range (IQR), 18–81] vs 78.5 [IQR, 47–107]), and discharged with a lower functional level (median total FIM score, 98 [IQR, 40–116] vs 110 [IQR, 82.5–119]), although they made more progress during neurorehabilitation (median change in total FIM score, 27 [IQR, 4–60] vs 17 [IQR, 7–35]). Statistically, patients with nontraumatic SAH had significantly better odds for obtaining functional independence than did patients with ICH/AIS in 6 of the 18 FIM items: eating (odds ratio [OR]=3.2; 95% confidence interval [CI], 1.7–5.8); dressing–upper body (OR=2.0; 95% CI, 1.1–3.5); transfer tub/shower (OR=2.0; 95% CI, 1.1–3.6); stair walking (OR=2.2; 95% CI, 1.3–3.7); comprehension (OR=2.3; 95% CI, 1.3–3.9); and expression (OR=3.6; 95% CI, 2.0–6.5).ConclusionsPatients with nontraumatic SAH made significantly more progress during neurorehabilitation, although they were discharged with a lower level of functional independence compared with patients with ICH/AIS. However, both patients with nontraumatic SAH and those with ICH/AIS improved their functional outcome significantly. Also, patients with nontraumatic SAH admitted with severe functional outcome were shown to be capable of recovering to a moderate level of functional independence.

AB - ObjectiveTo compare the changes in functional independence measured by the FIM after specialized neurorehabilitation between patients with nontraumatic subarachnoid hemorrhage (SAH) and patients with intracerebral hemorrhage (ICH) or acute ischemic stroke (AIS).DesignHistorical cohort study comparing changes in functional independence between patients with nontraumatic SAH and those with ICH/AIS, using FIM scores from a local database and clinical information from the Danish National Patient Registry.SettingPostacute specialized inpatient neurorehabilitation.ParticipantsParticipants (N=660) comprised patients with a first-time nontraumatic SAH (n=212) and age-matched patients with a first-time ICH/AIS (n=448).InterventionsNot applicable.Main Outcome MeasuresCrude and adjusted comparisons of FIM (total and item by item) measured at baseline and at discharge.ResultsPatients with nontraumatic SAH were admitted with a lower functional level compared with patients with ICH/AIS (median total FIM score, 25 [interquartile range (IQR), 18–81] vs 78.5 [IQR, 47–107]), and discharged with a lower functional level (median total FIM score, 98 [IQR, 40–116] vs 110 [IQR, 82.5–119]), although they made more progress during neurorehabilitation (median change in total FIM score, 27 [IQR, 4–60] vs 17 [IQR, 7–35]). Statistically, patients with nontraumatic SAH had significantly better odds for obtaining functional independence than did patients with ICH/AIS in 6 of the 18 FIM items: eating (odds ratio [OR]=3.2; 95% confidence interval [CI], 1.7–5.8); dressing–upper body (OR=2.0; 95% CI, 1.1–3.5); transfer tub/shower (OR=2.0; 95% CI, 1.1–3.6); stair walking (OR=2.2; 95% CI, 1.3–3.7); comprehension (OR=2.3; 95% CI, 1.3–3.9); and expression (OR=3.6; 95% CI, 2.0–6.5).ConclusionsPatients with nontraumatic SAH made significantly more progress during neurorehabilitation, although they were discharged with a lower level of functional independence compared with patients with ICH/AIS. However, both patients with nontraumatic SAH and those with ICH/AIS improved their functional outcome significantly. Also, patients with nontraumatic SAH admitted with severe functional outcome were shown to be capable of recovering to a moderate level of functional independence.

KW - Functional independence following neurorehabilitation

UR - http://dx.doi.org/10.1016/j.apmr.2016.11.010

M3 - Journal article

VL - 98

SP - 759

EP - 765

JO - Archives of Physical Medicine and Rehabilitation

T2 - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 4

ER -