Article

OBJECTIVE: To investigate whether self-exercise programs for patients after
stroke contribute to improved activities of daily living (ADL) at hospital discharge. DESIGN: Retrospective, observational, propensity score (PS)-matched
case-control study.
SETTING: General hospitals. PARTICIPANTS: Participants
included patients after stroke
(N=1560) hospitalized between January 3, 2006, and
December 26, 2012, satisfying the following criteria:
(1) data on age, sex,
duration from stroke to hospital admission, length of stay, FIM score, modified
Rankin Scale (mRS) score, Glasgow Coma Scale score, Japan Stroke Scale score, and
self-exercise program participation were available; and (2) admitted within 7
days after stroke onset, length of stay was between 7 and 60 days, prestroke mRS
score was </=2, and not discharged because of FIM or mRS exacerbation. A total of
780 PS-matched pairs were selected for each of the self-exercise program and
no-self-exercise program groups. INTERVENTION:
Self-exercise program
participation. MAIN OUTCOME MEASURES: At discharge, FIM motor score, FIM
cognitive score, FIM motor score gain (discharge value - admission value), FIM
motor score gain rate (gain/length of stay), a binary variable divided by the
median FIM motor score gain rate (high efficiency or no-high efficiency), and mRS
score. RESULTS: Patients were classified into a self-exercise program (n=780) or
a no-self-exercise program (n=780) group. After matching, there were no
significant between-group differences, except motor system variables. The
receiver operating characteristic curve for PS had an area under the curve value
of .71 with a 95% confidence interval of .68 to .73, and the model was believed
to have a relatively favorable fit. A logistic regression analysis of PS-matched
pairs suggested that the self-exercise program was effective, with an overall
odds ratio for ADL (high efficiency or no-high efficiency)
of 2.2 (95% confidence
ratio, 1.75-2.70). CONCLUSIONS: SEPs may contribute to improving ADL.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS