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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
Official Journal of the , , , ,
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 2000 Marzo;35(1):3-8
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.