PMID- 37579640
OWN - NLM
STAT- MEDLINE
DCOM- 20230925
LR  - 20230925
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Linking)
VI  - 32
IP  - 10
DP  - 2023 Oct
TI  - Tele-rehabilitation on independence in activities of daily living after stroke: A 
      Matched Case-Control Study.
PG  - 107267
LID - S1052-3057(23)00290-2 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2023.107267 [doi]
AB  - OBJECTIVES: To compare independence in activities of daily living (ADLs) in 
      post-acute patients with stroke following tele-rehabilitation and matched 
      in-person controls. MATERIALS AND METHODS: Matched case-control study. A total of 
      35 consecutive patients with stroke who followed tele-rehabilitation were 
      compared to 35 historical in-person patients (controls) matched for age, 
      functional independence at admission and time since injury to rehabilitation 
      admission (<60 days). The tele-rehabilitation group was also compared to the 
      complete cohort of historical controls (n=990). Independence in ADLs was assessed 
      using the Functional Independence Measure (FIM) and the Barthel Index (BI). We 
      formally compared FIM and BI gains calculated as discharge score - admission 
      scores, efficiency measured as gains / length of stay and effectiveness defined 
      as (discharge score-admission score)/ (maximum score-admission score). We 
      analyzed the minimal clinically important difference (MCID) for FIM and BI. 
      RESULTS: The groups showed no significant differences in type of stroke (ischemic 
      or hemorrhagic), location, severity, age at injury, length of stay, body mass 
      index, diabetes, dyslipidemia, hypertension, aphasia, neglect, affected side of 
      the body, dominance or educational level. The groups showed no significant 
      differences in gains, efficiency nor effectiveness either using FIM or Barthel 
      Index. We identified significant differences in two specific BI items (feeding 
      and transfer) in favor of the in-person group. No differences were observed in 
      the proportion of patients who achieved MCID. CONCLUSIONS: No significant 
      differences were seen between total ADL scores for tele-rehabilitation and 
      in-person rehabilitation. Future research studies should analyze a combined 
      rehabilitation approach that utilizes both models.
CI  - Copyright (c) 2023. Published by Elsevier Inc.
FAU - Garcia-Rudolph, Alejandro
AU  - Garcia-Rudolph A
AD  - Department of Research and Innovation, Institut Guttmann, Institut Universitari 
      de Neurorehabilitacio adscrit a la UAB, Badalona, Barcelona, Spain; Universitat 
      Autonoma de Barcelona, Bellaterra (Cerdanyola del Valles), Spain; Fundacio 
      Institut d'Investigacio en Ciencies de la Salut Germans Trias i Pujol, Badalona, 
      Barcelona, Spain. Electronic address: alejandropablogarcia@gmail.com.
FAU - Wright, Mark Andrew
AU  - Wright MA
AD  - Department of Research and Innovation, Institut Guttmann, Institut Universitari 
      de Neurorehabilitacio adscrit a la UAB, Badalona, Barcelona, Spain; Universitat 
      Autonoma de Barcelona, Bellaterra (Cerdanyola del Valles), Spain; Fundacio 
      Institut d'Investigacio en Ciencies de la Salut Germans Trias i Pujol, Badalona, 
      Barcelona, Spain. Electronic address: mawright@guttmann.com.
FAU - Murillo, Narda
AU  - Murillo N
AD  - Department of Research and Innovation, Institut Guttmann, Institut Universitari 
      de Neurorehabilitacio adscrit a la UAB, Badalona, Barcelona, Spain; Universitat 
      Autonoma de Barcelona, Bellaterra (Cerdanyola del Valles), Spain; Fundacio 
      Institut d'Investigacio en Ciencies de la Salut Germans Trias i Pujol, Badalona, 
      Barcelona, Spain. Electronic address: nmurillo@guttmann.com.
FAU - Opisso, Eloy
AU  - Opisso E
AD  - Department of Research and Innovation, Institut Guttmann, Institut Universitari 
      de Neurorehabilitacio adscrit a la UAB, Badalona, Barcelona, Spain; Universitat 
      Autonoma de Barcelona, Bellaterra (Cerdanyola del Valles), Spain; Fundacio 
      Institut d'Investigacio en Ciencies de la Salut Germans Trias i Pujol, Badalona, 
      Barcelona, Spain. Electronic address: eopisso@guttmann.com.
FAU - Medina, Josep
AU  - Medina J
AD  - Department of Research and Innovation, Institut Guttmann, Institut Universitari 
      de Neurorehabilitacio adscrit a la UAB, Badalona, Barcelona, Spain; Universitat 
      Autonoma de Barcelona, Bellaterra (Cerdanyola del Valles), Spain; Fundacio 
      Institut d'Investigacio en Ciencies de la Salut Germans Trias i Pujol, Badalona, 
      Barcelona, Spain. Electronic address: jmedina@guttmann.com.
LA  - eng
PT  - Journal Article
DEP - 20230812
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
SB  - IM
MH  - Humans
MH  - Infant
MH  - Activities of Daily Living
MH  - Case-Control Studies
MH  - *Telerehabilitation
MH  - *Stroke Rehabilitation
MH  - *Stroke/diagnosis/therapy
MH  - Recovery of Function
MH  - Treatment Outcome
MH  - Retrospective Studies
OTO - NOTNLM
OT  - activities of daily living
OT  - functional independence
OT  - stroke
OT  - tele-rehabilitation
COIS- Declaration of Competing Interest The authors report no conflict of interest
EDAT- 2023/08/15 00:42
MHDA- 2023/09/25 06:42
CRDT- 2023/08/14 18:06
PHST- 2023/03/12 00:00 [received]
PHST- 2023/06/07 00:00 [revised]
PHST- 2023/07/17 00:00 [accepted]
PHST- 2023/09/25 06:42 [medline]
PHST- 2023/08/15 00:42 [pubmed]
PHST- 2023/08/14 18:06 [entrez]
AID - S1052-3057(23)00290-2 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2023.107267 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2023 Oct;32(10):107267. doi: 
      10.1016/j.jstrokecerebrovasdis.2023.107267. Epub 2023 Aug 12.