PMID- 31693848
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2234-0645 (Print)
IS  - 2234-0653 (Electronic)
IS  - 2234-0645 (Linking)
VI  - 43
IP  - 5
DP  - 2019 Oct
TI  - Effectiveness of Family-Engaged Multidimensional Team Planning and Management for 
      Recovery in Patients With Severe Stroke and Low Functional Status.
PG  - 581-591
LID - 10.5535/arm.2019.43.5.581 [doi]
AB  - OBJECTIVE: To evaluate the effectiveness of family-engaged multidimensional team 
      planning and management for patients with severe stroke and low functional status 
      and to identify factors predictive of improved outcome at 1 month after 
      admission. METHODS: We retrospectively evaluated 50 patients who underwent 
      family-engaged multidimensional rehabilitation for recovery from severe stroke 
      due to primary unilateral cerebral lesions. The rehabilitation consisted of three 
      phases: comprehensive multidimensional assessment, intensive rehabilitation, and 
      evaluation. Functional Independence Measure (FIM) scores were calculated and used 
      to predict the patients' status at discharge. RESULTS: Although all FIM scores 
      significantly improved after 1 month of rehabilitation, the motor FIM (mFIM) 
      score improved the most (from 20.5+/-1.0 to 32.6+/-2.0). The total FIM (tFIM) and 
      mFIM scores continued to improve from the first month to discharge (mean mFIM 
      efficiency, 0.33). The high-efficiency patient group (mFIM efficiency >/=0.19) had 
      a significantly higher discharge-to-home rate (44% vs. 13%), lower frequency of 
      hemispatial neglect, and more severe finger numbness than the low-efficiency 
      patient group (mFIM efficiency <0.19). The regression analyses revealed that 
      besides lower mFIM and cognitive FIM scores at admission, unilateral spatial 
      neglect, systemic comorbidities, and age were predictive of worse 1-month 
      outcomes and tFIM scores (conformity, R2=0.78; predictive power, Akaike 
      information criterion value=202). CONCLUSION: Family-engaged multidimensional 
      team planning and management are useful for patients with severe stroke and low 
      functional status. Furthermore, FIM scores at admission, age, unilateral spatial 
      neglect, and systemic comorbidities should be considered by rehabilitation teams 
      when advising caregivers on the probability of favorable outcomes after 
      rehabilitation.
FAU - Hiragami, Fukumi
AU  - Hiragami F
AD  - Research Institute of Health and Welfare, Kibi International University, 
      Takahashi, Japan.
FAU - Hiragami, Shogo
AU  - Hiragami S
AD  - Department of Occupational Therapy, School of Rehabilitation, Hyogo University of 
      Health Sciences, Kobe, Japan.
FAU - Inoue, Yu
AU  - Inoue Y
AD  - Research Institute of Health and Welfare, Kibi International University, 
      Takahashi, Japan.
LA  - eng
GR  - 24616025/Japan Society for the Promotion of Science/
GR  - 16K09193/Japan Society for the Promotion of Science/
PT  - Journal Article
DEP - 20191031
PL  - Korea (South)
TA  - Ann Rehabil Med
JT  - Annals of rehabilitation medicine
JID - 101573065
PMC - PMC6835136
OTO - NOTNLM
OT  - Cerebrovascular disorders
OT  - Dependency
OT  - Rehabilitation
OT  - Stroke
OT  - Symptom assessment
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2019/11/07 06:00
MHDA- 2019/11/07 06:01
PMCR- 2019/10/01
CRDT- 2019/11/07 06:00
PHST- 2018/11/15 00:00 [received]
PHST- 2019/05/21 00:00 [accepted]
PHST- 2019/11/07 06:00 [entrez]
PHST- 2019/11/07 06:00 [pubmed]
PHST- 2019/11/07 06:01 [medline]
PHST- 2019/10/01 00:00 [pmc-release]
AID - arm.2019.43.5.581 [pii]
AID - arm-2019-43-5-581 [pii]
AID - 10.5535/arm.2019.43.5.581 [doi]
PST - ppublish
SO  - Ann Rehabil Med. 2019 Oct;43(5):581-591. doi: 10.5535/arm.2019.43.5.581. Epub 
      2019 Oct 31.