Topics in Stroke Rehabilitation最新文献_第6页

Determinants of access to rehabilitation professionals by individuals with stroke in the first six months after hospital discharge in Brazil: a study based on the Andersen model. 巴西中风患者出院后头六个月接触康复专业人员的决定因素：基于安德森模型的研究。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-09-01 Epub Date: 2024-02-06 DOI: 10.1080/10749357.2024.2304969

Jordana P Magalhães, Iza Faria-Fortini, Kênia Kp Menezes, Isadora A Lara, Ludmilla R Batista, Romeu Sant'anna, Christina Dcm Faria

{"title":"Determinants of access to rehabilitation professionals by individuals with stroke in the first six months after hospital discharge in Brazil: a study based on the Andersen model.","authors":"Jordana P Magalhães, Iza Faria-Fortini, Kênia Kp Menezes, Isadora A Lara, Ludmilla R Batista, Romeu Sant'anna, Christina Dcm Faria","doi":"10.1080/10749357.2024.2304969","DOIUrl":"10.1080/10749357.2024.2304969","url":null,"abstract":"Background: determinants of access to rehabilitation professionals after stroke in middle-income countries, where the burden of this disease is higher, are little known.Objectives: To identify the determinants of access to rehabilitation professionals by individuals with stroke at one, three, and six months after hospital discharge in Brazil and compare referral and access rates after discharge.Methods: Longitudinal and prospective study, with individuals with primary stroke, without previous disabilities. At hospital discharge, the number of rehabilitation professionals referred by the multidisciplinary team was recorded. The possible determinants of access, according to Andersen's model, were: a) predisposing factors: age, sex, education levels, and belief that they could improve with treatment; b) need factors: stroke severity, levels of disability; c) enabling factors: socioeconomic status, disposable income for health care, and quality of care provided by rehabilitation professionals. One, three, and six months after hospital discharge, individuals were contacted to identify which rehabilitation professionals were accessed. Multiple linear regression model and Wilcoxon tests were used (α=5%).Results: 201 individuals were included. Disability levels and stroke severity explained 31%, 34%, and 39% (p<0.01) of access at one, three, and six months after hospital discharge, respectively. In all periods, there was less access than that recommended at the time of hospital discharge (p<0.01).Conclusion: Need factors (disability levels and stroke severity) were determinants of access in all assessed periods. In addition, in all periods, the comprehensiveness of care for individuals with stroke was compromised.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"615-624"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between energy intake and activities of daily living in patients with acute stroke at hospital discharge: a retrospective cohort study. 急性脑卒中患者出院时的能量摄入与日常生活活动之间的关系：一项回顾性队列研究。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-08-29 DOI: 10.1080/10749357.2024.2392446

Masafumi Nozoe, Tatsuro Inoue, Miho Yamamoto, Rio Ikeji, Haruka Seike, Masato Ogawa

{"title":"Association between energy intake and activities of daily living in patients with acute stroke at hospital discharge: a retrospective cohort study.","authors":"Masafumi Nozoe, Tatsuro Inoue, Miho Yamamoto, Rio Ikeji, Haruka Seike, Masato Ogawa","doi":"10.1080/10749357.2024.2392446","DOIUrl":"10.1080/10749357.2024.2392446","url":null,"abstract":"Objective: This study aimed to investigate the effects of energy intake on activities of daily living (ADL) in patients with acute stroke, with a focus on the differences between obese and non-obese patients.Methods: This retrospective observational study was conducted in a neurological hospital and included patients hospitalized for acute stroke. During the acute phase (1 week after admission), energy intake was assessed, and the main outcome was defined as the Functional Independence Measure in the motor domain (FIM-M) at discharge. All subjects were divided into two groups based on their body mass index (BMI) at admission, with BMI ≥ 25 defining the obese stroke group and BMI < 25 defining the non-obese stroke group. Linear regression analysis was performed to examine the relationship between energy intake and FIM-M in each group.Results: A total of 307 patients with acute stroke (median age: 72 years) were included in this study, with 118 patients (39%) in the obese stroke group. In the non-obese stroke group, a significant and independent relationship was observed between FIM-M and energy intake (β = 0.103, p = 0.031, adjusted R2 = 0.687). However, in the obese stroke group, no significant relationship was found between FIM-M and energy intake (β = 0.076, p = 0.302).Conclusion: In patients with acute stroke, energy intake positively affects functional outcomes in non-obese patients but not in obese patients. This study highlights the importance of considering obesity as a potential factor in determining energy intake in patients with acute stroke.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of stroke patients undergoing percutaneous endoscopic gastrostomy: a systematic review and meta-analysis. 接受经皮内镜胃造瘘术的中风患者的预后：系统回顾和荟萃分析。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-08-27 DOI: 10.1080/10749357.2024.2392441

Mohammed Maan Al-Salihi, Syed A Gillani, Ram Saha, Ahmed Abd Elazim, Maryam Sabah Al-Jebur, Shamser Singh Dalal, Farhan Siddiq, Ali Ayyad, Camilo R Gomez, Adnan I Qureshi

{"title":"Outcomes of stroke patients undergoing percutaneous endoscopic gastrostomy: a systematic review and meta-analysis.","authors":"Mohammed Maan Al-Salihi, Syed A Gillani, Ram Saha, Ahmed Abd Elazim, Maryam Sabah Al-Jebur, Shamser Singh Dalal, Farhan Siddiq, Ali Ayyad, Camilo R Gomez, Adnan I Qureshi","doi":"10.1080/10749357.2024.2392441","DOIUrl":"https://doi.org/10.1080/10749357.2024.2392441","url":null,"abstract":"Background: Percutaneous endoscopic gastrostomy (P.E.G.) is recommended for stroke patients with dysphagia to sustain oral nutrition.Objective: This study assesses the outcomes of stroke patients undergoing P.E.G. compared with those requiring nasogastric tube (N.G.T) or control group.Methods: We performed a thorough search across five electronic databases to gather pertinent studies. Outcomes were analyzed using relative risk (R.R.) for categorical data and mean difference (M.D.) for continuous data, each with 95% confidence intervals (C.I.). The single-arm meta-analysis results were presented as proportions or mean changes, also with 95% C.I.Results: We included 22 studies consisting of 996,567 patients. Our double-arm meta-analysis (924,134 patients) revealed no significant difference in post-hospitalization or in-hospital mortality between P.E.G. and control groups. However, P.E.G. patients showed a higher risk of aspiration pneumonia than control (R.R. = 11.72[3.75, 36.62], p < 0.00001). A comparison of P.E.G. and N.G.T. in three studies involving 691 patients indicated a non-significant difference in-hospital mortality risk (R.R. = 0.59, 95% C.I. [0.2, 1.72]). The single-arm analysis of stroke patients with P.E.G. identified a 19.8% in-hospital mortality, 13.6% rate of aspiration pneumonia, and 58% rate of pneumonia.Conclusion: Stroke patients undergoing P.E.G remain at high risk for aspiration pneumonia and with an in-hospital mortality suggesting the need for identifying the best candidates and timing for the procedure.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Telerehabilitation in post-stroke care: a systematic review and meta-analysis of randomized controlled trials. 中风后护理中的远程康复：随机对照试验的系统回顾和荟萃分析。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-08-22 DOI: 10.1080/10749357.2024.2392439

Aakanksha Pitliya, Anas Bin Siddiq, Deva Oli, Jeremiah Hilkiah Wijaya, Vanshika Batra, Srivatsa Surya Vasudevan, Jinal Choudhari, Ramit Singla, Anmol Pitliya

{"title":"Telerehabilitation in post-stroke care: a systematic review and meta-analysis of randomized controlled trials.","authors":"Aakanksha Pitliya, Anas Bin Siddiq, Deva Oli, Jeremiah Hilkiah Wijaya, Vanshika Batra, Srivatsa Surya Vasudevan, Jinal Choudhari, Ramit Singla, Anmol Pitliya","doi":"10.1080/10749357.2024.2392439","DOIUrl":"https://doi.org/10.1080/10749357.2024.2392439","url":null,"abstract":"Objectives: This meta-analysis introduces tele-medicine in time-sensitive conditions like stroke and the challenges hindering at-home rehabilitation. It aims to consolidate evidence supporting telerehabilitation effectiveness in post-stroke patients, with a focus on ADL, balance, mobility, and motor control.Methods: We conducted a meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines. A comprehensive search of PubMed, Google Scholar, and Cochrane central databases was conducted. Inclusion criteria involved studies that employed randomized controlled trial (RCT) designs, specifically evaluating various telerehabilitation models in patients diagnosed with a stroke, excluding those with mixed etiology and non-randomized or single-arm designs. Two independent reviewers assessed study quality and bias using Cochrane Risk of Bias 2 before inclusion.Results: We included 10 studies (n = 417) with a predominantly male sample (n = 196). The mean age of the pooled sample of 8 studies was 64.87 (13.01) years. Our meta-analysis showed that telerehabilitation may have modest effects on Berg Balance Scale (SMD 0.08 [-0.23; 0.40]; p = 0.54), and trunk impairment scale (SMD 0.26 [-1.00; 1.52]; p = 0.05), slightly inferior effects on Barthel index (SMD -0.34 [-1.00; 0.32]; p = 0.31), but demonstrated a favorable impact on trunk impairment (SMD -0.21 [-1.18; 0.76]; p = 0.02).Conclusion: We found that telerehabilitation may have modest effects on balance and mobility, and slightly inferior results in Activities of daily living but may have a positive effect on trunk impairment. However, more studies with larger cohorts are needed to confirm our results.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-08-22 DOI: 10.1080/10749357.2024.2392447

Stéphanie Goncalves, Morgane Le Bourvellec, Noémie C Duclos, Stéphane Mandigout

{"title":"Recommended moderate to vigorous physical activity levels for people in the chronic phase of stroke can be achieved in outpatient physiotherapy: a multicentre observational study.","authors":"Stéphanie Goncalves, Morgane Le Bourvellec, Noémie C Duclos, Stéphane Mandigout","doi":"10.1080/10749357.2024.2392447","DOIUrl":"https://doi.org/10.1080/10749357.2024.2392447","url":null,"abstract":"Background: Rehabilitation in the chronic phase of stroke should include 20 minutes of moderate to vigorous physical activity (MVPA). However, the level of compliance with MVPA guidelines in outpatient physiotherapy is unknown.Objectives: To investigate (1) whether people in the chronic phase of stroke perform the recommended 20 minutes of MVPA during outpatient physiotherapy sessions in France, (2) whether the person's clinical characteristics influence MVPA time and (3) which interventions contribute to achievement of recommended MVPA time.Methods: This was a multicentre, cross-sectional observational study of routine outpatient physiotherapy sessions in France in people in the chronic phase of stroke. The main measures included MVPA time (determined using a heart rate monitor), clinical tests and types of physiotherapy interventions (recorded by external investigator during 2 sessions for each participant).Results: 84 people in the chronic phase of stroke and 152 outpatient physiotherapy sessions in 29 outpatient clinics were included (2021-2022). Median (interquartile range) MVPA time was 25 (7-45) minutes across all sessions. Fifty-nine percent of the sessions fulfilled MVPA guidelines. Among clinical tests, only the Mini-Mental Scale Examination was significantly associated with MVPA time. Endurance, balance, and functional lower limb training were associated with the achievement of MVPA guidelines.Conclusion: Outpatient physiotherapy sessions have the potential to meet the MVPA guidelines. Further research is needed to understand the variability of compliance with MVPA guidelines and to develop strategies to increase the integration of MVPA into outpatient physiotherapy sessions.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The mediating roles of caregiver needs and caregiver readiness in the relation between family resilience and benefit finding in family caregivers of patients with stroke in China. 中国脑卒中患者家庭照护者的照护者需求和照护者准备在家庭复原力与受益发现之间的中介作用。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-08-14 DOI: 10.1080/10749357.2024.2387482

Qitong Zhao, Xinyue Zhao, Jingwei Zhang, Xiangmin Xu, Haoxin Kong, Shuhao Lin, Haijun Zhao, Mingxia Li

{"title":"The mediating roles of caregiver needs and caregiver readiness in the relation between family resilience and benefit finding in family caregivers of patients with stroke in China.","authors":"Qitong Zhao, Xinyue Zhao, Jingwei Zhang, Xiangmin Xu, Haoxin Kong, Shuhao Lin, Haijun Zhao, Mingxia Li","doi":"10.1080/10749357.2024.2387482","DOIUrl":"https://doi.org/10.1080/10749357.2024.2387482","url":null,"abstract":"Objectives: The purpose of this study was to assess the effects of family resilience, caregiver needs, and caregiver readiness on benefit finding for family caregivers of patients with stroke and to examine the mediating role of caregiver needs and caregiver readiness between family resilience and benefit finding.Methods: In this cross-sectional study, convenience sampling was designed and used to recruit participants from three general hospitals in Jinan, Shandong Province, China, from February to September 2022, in which 340 participants completed the General Information Questionnaire, Chinese version of the Family Resilience Assessment Scale (C-FRAS), Caregiver Needs Assessment Scale (CNAS) Chinese version of the Caregiver Preparedness Scale (C-CPS), and Caregiver Benefit Finding Scale (CBFS). Model 6 in process version 4.0 was used to test the chain mediation model between family resilience and benefit finding for caregiver needs and caregiver readiness.Results: Correlation analysis showed that benefit finding in family caregivers was positively associated with family resilience and caregiver readiness and negatively associated with caregiver needs; mediation model tests showed that the total indirect effect of family resilience on benefit finding was 0.163, with the specific mediating effects of caregiver needs and caregiver readiness accounting for 33.74% and 59.51%, and the chain mediating effect of both accounting for 6.75%.Conclusions: Family resilience not only directly influences benefit finding for family caregivers but also indirectly affects benefit finding through caregiver needs and caregiver readiness. Caregiver needs and caregiver readiness have a mediating role between family resilience and benefit finding in family caregivers.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inferior vena cava filter migration to the heart after stroke: a case report. 中风后下腔静脉过滤器移位至心脏：病例报告。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-08-10 DOI: 10.1080/10749357.2024.2387481

Daniel A Goodman, Ellen Farr, Leslie Rydberg

{"title":"Inferior vena cava filter migration to the heart after stroke: a case report.","authors":"Daniel A Goodman, Ellen Farr, Leslie Rydberg","doi":"10.1080/10749357.2024.2387481","DOIUrl":"https://doi.org/10.1080/10749357.2024.2387481","url":null,"abstract":"This case report discusses the functional outcomes and multidisciplinary coordination of care for a patient with hemiplegia due to stroke complicated by a migrated inferior vena cava (IVC) filter embedded in the right side of the heart. The patient suffered an acute right-sided stroke with hemorrhagic transformation requiring hemicraniectomy with left hemiplegia. The patient developed a subsequent pulmonary embolism requiring IVC filter placement as anticoagulation was contraindicated due to risk of further intracranial hemorrhage. The IVC filter was later identified bridging the tricuspid valve, and surgical intervention was contraindicated requiring a coordinated plan to delay surgical removal of the filter in order to allow for optimization of the patient's functional and medical status. The patient underwent extensive telemetry monitoring in the intensive care unit to verify no significant cardiac arrhythmia developed with physical activity and was ultimately cleared for admission to acute inpatient rehabilitation. There was a well-coordinated effort between the cardiac, surgical, intensive care, and rehabilitation teams to transition to the inpatient rehabilitation facility to minimize risk and enhance recovery. The patient demonstrated functional improvement throughout rehabilitation and was discharged home with family with eventual surgical removal of the IVC filter. This case highlights the importance of collaboration across multiple disciplines to maximize patient rehabilitation and function, particularly in the context of atypical complications.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-5"},"PeriodicalIF":2.2,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minorities are under-reported and females are under-represented in stroke motor recovery trials. 在脑卒中运动恢复试验中，少数族裔的报告不足，女性代表不足。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-07-29 DOI: 10.1080/10749357.2024.2384324

Sara Hassani, Tarek Bou Dargham, Sarah Cantrell, Salman Ikramuddin, Wuwei Feng

{"title":"Minorities are under-reported and females are under-represented in stroke motor recovery trials.","authors":"Sara Hassani, Tarek Bou Dargham, Sarah Cantrell, Salman Ikramuddin, Wuwei Feng","doi":"10.1080/10749357.2024.2384324","DOIUrl":"https://doi.org/10.1080/10749357.2024.2384324","url":null,"abstract":"Background: Inclusion of diverse patient populations in stroke rehabilitation clinical trials is key for generalizability and detecting differences in subgroups. The aim of this study was to assess the reporting and inclusion of race, ethnicity, and sex in publications in post-stroke motor recovery clinical trials over the past 5 years.Methods: We conducted a systematic review of stroke motor recovery trials conducted only within the United States with at least one control group and published between 2019 and 2023. The percent of racial minorities, ethnicities, and women enrolled in the trials was extracted and calculated for those trials using available data found in the manuscript or on clinicaltrials.gov.Results: Sixty-eight trials (total of 2,801 participants) met the inclusion criteria and were included in the analysis. 100%, 35%, and 21% of the trials included reported enrollment by sex, race, and ethnicity in the manuscript. All publications reported sex and 38% of the subjects were female. Among the trials reporting race, 59% of the participants were White, followed by 34% Black, 0.4% Native American, 4% Asian, and 3% Other. Among the trials that reported ethnicity, Hispanic or Latino participants were represented as 13% of the total participants.Conclusions: In the past 5 years, while all stroke rehab trial publications reported data on sex, they underrepresented women. Most publications did not report race or ethnicity. Improvement in reporting of race/ethnicity in stroke motor recovery trials is needed for understanding of progress with inclusion, and improvement in inclusion of women is needed for better generalizability.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-5"},"PeriodicalIF":2.2,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gender differences in participation one year after stroke: exploring biopsychosocial predictors for women and men. 中风一年后参与活动的性别差异：探索女性和男性的生物心理社会预测因素。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-07-24 DOI: 10.1080/10749357.2024.2377518

Joris A de Graaf, Sanne van Miltenburg, Marieke J H Wermer, Marcel W M Post, Johanna M A Visser-Meily

{"title":"Gender differences in participation one year after stroke: exploring biopsychosocial predictors for women and men.","authors":"Joris A de Graaf, Sanne van Miltenburg, Marieke J H Wermer, Marcel W M Post, Johanna M A Visser-Meily","doi":"10.1080/10749357.2024.2377518","DOIUrl":"https://doi.org/10.1080/10749357.2024.2377518","url":null,"abstract":"Background: Women appear to have a higher risk for long term restrictions in participation than men. This gender difference is poorly understood, as solely biomedical factors have been examined to date.Objectives: The aims of this study are (1) to map gender differences in participation outcome one year after stroke, and (2) to identify demographic, stroke-related, or psychological predictors of participation for women and men separately.Methods: A total of 326 patients (mean age 66.5 ± 12.4y, 35.0% women) completed the restriction and satisfaction subscales of the Utrecht Scale of Evaluation of Rehabilitation-Participation (USER-P) at one year after stroke. Bivariate and multiple linear regression analyses were performed.Results: Women reported worse scores for restrictions in participation compared to men (median 75.4 versus 87.9 respectively, p = 0.001), especially in physical activities such as daytrips and going out. Satisfaction with participation was similar between women and men. Worse cognitive functioning (β = 0.17) was associated with more restrictions in participation in men only, other predictors of restrictions in participation were similar between women and men. The presence of depressive symptoms (β = -0.49) was associated with worse satisfaction with participation in men, whereas an increased stroke severity (β = -0.29) and the presence of maladaptive psychological factors (β = -0.36) were associated with worse satisfaction with participation in women.Conclusions: Women experience more restrictions in participation compared to men one year after stroke. Taking into account gender-specific predictors of participation in stroke aftercare is important, as different biopsychosocial factors contribute to problems in participation across women and men.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prediction model of malnutrition in hospitalized patients with acute stroke. 急性脑卒中住院患者营养不良预测模型。

IF 2.2 4区医学

Topics in Stroke Rehabilitation Pub Date : 2024-07-18 DOI: 10.1080/10749357.2024.2377521

Rong Tang, Bi Guan, Jiaoe Xie, Ying Xu, Shu Yan, Jianghong Wang, Yan Li, Liling Ren, Haiyan Wan, Tangming Peng, Liangnan Zeng

{"title":"Prediction model of malnutrition in hospitalized patients with acute stroke.","authors":"Rong Tang, Bi Guan, Jiaoe Xie, Ying Xu, Shu Yan, Jianghong Wang, Yan Li, Liling Ren, Haiyan Wan, Tangming Peng, Liangnan Zeng","doi":"10.1080/10749357.2024.2377521","DOIUrl":"10.1080/10749357.2024.2377521","url":null,"abstract":"Objective: The prognosis of stroke patients is greatly threatened by malnutrition. However, there is no model to predict the risk of malnutrition in hospitalized stroke patients. This study developed a predictive model for identifying high-risk malnutrition in stroke patients.Methods: Stroke patients from two tertiary hospitals were selected as the objects. Binary logistic regression was used to build the model. The model's performance was evaluated using various metrics including the receiver operating characteristic curve, Hosmer-Lemeshow test, sensitivity, specificity, Youden index, clinical decision curve, and risk stratification.Results: A total of 319 stroke patients were included in the study. Among them, 27% experienced malnutrition while in the hospital. The prediction model included all independent variables, including dysphagia, pneumonia, enteral nutrition, Barthel Index, upper arm circumference, and calf circumference (all p < 0.05). The AUC area in the modeling group was 0.885, while in the verification group, it was 0.797. The prediction model produces greater net clinical benefit when the risk threshold probability is between 0% and 80%, as revealed by the clinical decision curve. All p values of the Hosmer test were > 0.05. The optimal cutoff value for the model was 0.269, with a sensitivity of 0.849 and a specificity of 0.804. After risk stratification, the MRS scores and malnutrition incidences increased significantly with escalating risk levels (p < 0.05) in both modeling and validation groups.Conclusions: This study developed a prediction model for malnutrition in stroke patients. It has been proven that the model has good differentiation and calibration.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0