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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 2000 March;35(1):3-8

language: English

Impact of age on temporal, clinical and functional parameters of first-stroke inpatients undergoing rehabilitation

Ring H. 1, Tamir A. 2, Motin M. 1

1 Department of Neurological Rehabilitation, Loewenstein Hospital Rehabilitation Center, Raanana and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
2 Department of Epidemiology, Faculty of Medicine, Technological Institute of Israel (Technion), Haifa, Israel


BACKGROUND: The ­impact of age on the ben­e­fits of ­stroke ­unit reha­bil­i­ta­tion ­remains con­tro­ver­sial. To aid deci­sion mak­ing dur­ing the pro­cess of admis­sion of eld­er­ly ­stroke vic­tims for insti­tu­tion­al reha­bil­i­ta­tion, we exam­ined the influ­ence of age on ­major param­e­ters of reha­bil­i­ta­tive ­work.
METHODS: The ­study pop­u­la­tion con­sist­ed of all 596 ­patients ­after ­first ­brain ­stroke admit­ted to Loewenstein Rehabilitation Hospital, a lib­er­al-admis­sion, uni­ver­sity-affil­i­at­ed insti­tu­tion, ­from 1992 to 1996. Patients ­were divid­ed by age (<65 vs >65 ­years) and pres­ence of spe­cial syn­dromes (­neglect, apha­sia). The Functional Independence Measure (FIM) was admin­is­tered at admis­sion, 48-72 ­hours lat­er and at dis­charge. Total ­score and ­score on the Motor and Cognitive sub­scales ­were cal­cu­lat­ed. Rehabilitation effi­ca­cy was deter­mined by divid­ing the FIM ­gain by the ­length of ­stay.
RESULTS: The old­er ­group was char­ac­ter­ized by ­more clin­i­cal ­risk fac­tors and poor­er func­tion at all ­time ­points; how­ev­er, the dif­fer­ence in FIM ­gain by age was sta­tis­ti­cal­ly sig­nif­i­cant ­only for the Motor sub­scale. In ­both age ­groups, ­patients who ­were affect­ed by spe­cial syn­dromes ­fared ­worse ­than ­those who ­were not. All ­patients ­achieved the tar­get ­score of 90 ­except the old­er ­patients ­with spe­cial syn­dromes. Significantly long­er peri­ods of ­time ­were grant­ed for reha­bil­i­ta­tion to the young­er ­patients ­with spe­cial syn­dromes ­than to ­their old­er coun­ter­parts.
CONCLUSIONS: Older ­patients ­after ­first ­stroke ­have a ­good poten­tial for recov­ery ­with in-hos­pi­tal reha­bil­i­ta­tion, but ­they are ­more affect­ed by the pres­ence of spe­cial syn­dromes. These find­ings ­have impor­tant impli­ca­tions for the for­mu­la­tion of ­cost-effec­tive ther­a­peu­tic pro­to­cols in ­this pop­u­la­tion.

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