PMID- 25375185
OWN - NLM
STAT- MEDLINE
DCOM- 20160801
LR  - 20161125
IS  - 1973-9095 (Electronic)
IS  - 1973-9087 (Linking)
VI  - 51
IP  - 5
DP  - 2015 Oct
TI  - General cognition predicts post-stroke recovery defined through minimal 
      clinically important difference (MCID): a cohort study in an Italian 
      rehabilitation clinic.
PG  - 597-606
AB  - BACKGROUND: In the field of rehabilitation it is crucial to define if changes in 
      functional scores correspond to relevant clinical improvements. AIM: To assess 
      whether cognition affects motor recovery in post-stroke patients using a clinical 
      meaningful criterion: the minimal clinically important difference (MCID). DESIGN: 
      Retrospective cohort study. SETTING: Inpatient rehabilitation clinic POPULATION: 
      Two hundred nine first-ever stroke patients undergoing a post-acute inpatient 
      rehabilitation. METHODS: Cognitive status was assessed with the cognitive FIM and 
      the Mini-Mental State Examination (MMSE). The response to the rehabilitation was 
      defined as the achievement of the MCID between admission and discharge in the 
      motor FIM (responder) and both in the motor and in the cognitive FIM 
      (best-responder). RESULTS: Subjects with a baseline higher MMSE>24.9 had a near 
      four-fold higher probability of being responder (OR 3.91; 95% CI 1.72-8.89) and a 
      two-fold higher probability of being best-responder (OR 2.69; 95% CI 1.24-5.84) 
      on motor FIM as compared to those with a MMSE</=24.9. A duration of the 
      rehabilitation of 55-61 days implies a three-fold higher probability (OR 3.17; 
      95% CI 1.15-8.72) to be responder as compared to shorter period of treatment; a 
      treatment >61 days does not involve a greater probability of response. 
      CONCLUSIONS: This is the first study that examined post-stroke motor recovery 
      mainly in terms of clinical relevance (MCID). Subjects with a higher cognitive 
      level are more likely to achieve a clinically meaningful recovery. CLINICAL 
      REHABILITATION IMPACT: MCID can be applied extensively to post-stroke patients 
      undergoing to an inpatient rehabilitation in order to have a clinically useful 
      instrument that assess the recovery.
FAU - Ginex, V
AU  - Ginex V
AD  - Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy - 
      v.ginex@ccppdezza.it.
FAU - Vanacore, N
AU  - Vanacore N
FAU - Lacorte, E
AU  - Lacorte E
FAU - Sozzi, M
AU  - Sozzi M
FAU - Pisani, L
AU  - Pisani L
FAU - Corbo, M
AU  - Corbo M
FAU - Clerici, F
AU  - Clerici F
LA  - eng
PT  - Journal Article
DEP - 20141106
PL  - Italy
TA  - Eur J Phys Rehabil Med
JT  - European journal of physical and rehabilitation medicine
JID - 101465662
SB  - IM
MH  - Activities of Daily Living
MH  - Aged
MH  - Aged, 80 and over
MH  - Cognition/*physiology
MH  - Disability Evaluation
MH  - Female
MH  - Health Status Indicators
MH  - Humans
MH  - Italy
MH  - Male
MH  - Motor Activity/physiology
MH  - Physical Therapy Modalities
MH  - Prognosis
MH  - Recovery of Function
MH  - Rehabilitation Centers
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke/*physiopathology
MH  - *Stroke Rehabilitation
MH  - Treatment Outcome
EDAT- 2014/11/07 06:00
MHDA- 2016/08/02 06:00
CRDT- 2014/11/07 06:00
PHST- 2014/11/07 06:00 [entrez]
PHST- 2014/11/07 06:00 [pubmed]
PHST- 2016/08/02 06:00 [medline]
AID - R33Y9999N00A140375 [pii]
PST - ppublish
SO  - Eur J Phys Rehabil Med. 2015 Oct;51(5):597-606. Epub 2014 Nov 6.