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Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program.

Authors
  • Chu, Chan-Lin1, 2
  • Chen, Yueh-Peng3
  • Chen, Carl C P3, 4
  • Chen, Chih-Kuang3, 4
  • Chang, Hsiang-Ning4
  • Chang, Chien-Hung1, 2, 5
  • Pei, Yu-Cheng3, 4, 6, 7
  • 1 Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. , (Taiwan)
  • 2 School of Medicine, Chang Gung University, Taoyuan, Taiwan. , (Taiwan)
  • 3 Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. , (Taiwan)
  • 4 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. , (Taiwan)
  • 5 Department of Electrical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan. , (Taiwan)
  • 6 Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. , (Taiwan)
  • 7 Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. , (Taiwan)
Type
Published Article
Journal
Neuropsychiatric Disease and Treatment
Publisher
Dove Medical Press
Publication Date
Jan 01, 2020
Volume
16
Pages
1975–1985
Identifiers
DOI: 10.2147/NDT.S253700
PMID: 32884273
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Tailored rehabilitation programs for stroke patients cannot be made without knowledge of their recovery potential. The aim of this study is to characterize the functional recovery patterns of ischemic stroke (IS) and intracerebral hemorrhage (ICH) patients under post-acute care stroke rehabilitation. This retrospective study analyzed the data of patients enrolled in the Post-Acute Care-Cerebrovascular Disease (PAC-CVD) rehabilitation program, which provides an individualized 1- to 3-hour intensive physical, occupational, and speech and language therapy for post-acute stroke patients in Taoyuan Chang Gung Memorial hospital in Taiwan. Our primary endpoint measure was Barthel Index (BI), and secondary endpoint measures included other 12 functional measures. A total of 489 patients were included for analysis. Patients with stroke history had less BI improvement than those who suffered their first-ever stroke. In first-ever stroke patients who had completed 6 to 12 weeks of PAC-CVD program, subcortical ICH patients had greater BI, quality of life, sensation, and balance improvements, and had greater late-phase recovery than their IS counterparts. In IS patients, those with age >75 had less BI improvement; those with National Institute of Health Stroke Scale (NIHSS) score 1-5 had greater Motor Activity Log quality of use (MAL-quality) improvement than those with NIHSS score >5; those with Mini-Mental State Examination (MMSE) score ≥24 had greater BI and instrumental activities of daily living (IADL) improvement. Using the general linear model, previous stroke (ß: -6.148, p=0.01) and subcortical ICH (ß: 5.04, p=0.03) were factors associated with BI improvement. Subcortical ICH patients have greater functional improvement and greater late-phase recovery than their IS counterparts following PAC rehabilitation. More studies are needed to validate our findings and unravel the underlying mechanisms of stroke recovery to optimize the treatment strategy following a stroke. © 2020 Chu et al.

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