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Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici

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)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 2000 March;35(1):3-8

lingua: Inglese

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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