Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program

Chan-Lin Chu,1,2 Yueh-Peng Chen,3 Carl CP Chen,3,4 Chih-Kuang Chen,3,4 Hsiang-Ning Chang,4 Chien-Hung Chang,1,2,5,* Yu-Cheng Pei3,4,6,7,* 1Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 2School of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Center for Artifi...

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Autores principales:	Chu CL, Chen YP, Chen CCP, Chen CK, Chang HN, Chang CH, Pei YC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	activities of daily living functional recovery hemorrhagic stroke ischemic stroke post-acute care rehabilitation Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/8ad5dad5675344619373428306028974
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spelling	oai:doaj.org-article:8ad5dad56753446193734283060289742021-12-02T11:03:52ZFunctional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program1178-2021https://doaj.org/article/8ad5dad56753446193734283060289742020-08-01T00:00:00Zhttps://www.dovepress.com/functional-recovery-patterns-of-hemorrhagic-and-ischemic-stroke-patien-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Chan-Lin Chu,1,2 Yueh-Peng Chen,3 Carl CP Chen,3,4 Chih-Kuang Chen,3,4 Hsiang-Ning Chang,4 Chien-Hung Chang,1,2,5,* Yu-Cheng Pei3,4,6,7,* 1Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 2School of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 4Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 5Department of Electrical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan; 6Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; 7Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan*These authors contributed equally to this workCorrespondence: Yu-Cheng Pei; Chien-Hung Chang Email yspeii@gmail.com; cva9514@gmail.comBackground: Tailored rehabilitation programs for stroke patients cannot be made without knowledge of their recovery potential. The aim of this study is to characterize the functional recovery patterns of ischemic stroke (IS) and intracerebral hemorrhage (ICH) patients under post-acute care stroke rehabilitation.Methods: This retrospective study analyzed the data of patients enrolled in the Post-Acute Care-Cerebrovascular Disease (PAC-CVD) rehabilitation program, which provides an individualized 1- to 3-hour intensive physical, occupational, and speech and language therapy for post-acute stroke patients in Taoyuan Chang Gung Memorial hospital in Taiwan. Our primary endpoint measure was Barthel Index (BI), and secondary endpoint measures included other 12 functional measures.Results: A total of 489 patients were included for analysis. Patients with stroke history had less BI improvement than those who suffered their first-ever stroke. In first-ever stroke patients who had completed 6 to 12 weeks of PAC-CVD program, subcortical ICH patients had greater BI, quality of life, sensation, and balance improvements, and had greater late-phase recovery than their IS counterparts. In IS patients, those with age > 75 had less BI improvement; those with National Institute of Health Stroke Scale (NIHSS) score 1– 5 had greater Motor Activity Log quality of use (MAL-quality) improvement than those with NIHSS score > 5; those with Mini-Mental State Examination (MMSE) score ≥ 24 had greater BI and instrumental activities of daily living (IADL) improvement. Using the general linear model, previous stroke (ß: − 6.148, p=0.01) and subcortical ICH (ß: 5.04, p=0.03) were factors associated with BI improvement.Conclusion: Subcortical ICH patients have greater functional improvement and greater late-phase recovery than their IS counterparts following PAC rehabilitation. More studies are needed to validate our findings and unravel the underlying mechanisms of stroke recovery to optimize the treatment strategy following a stroke.Keywords: activities of daily living, functional recovery, hemorrhagic stroke, ischemic stroke, post-acute care, rehabilitationChu CLChen YPChen CCPChen CKChang HNChang CHPei YCDove Medical Pressarticleactivities of daily livingfunctional recoveryhemorrhagic strokeischemic strokepost-acute carerehabilitationNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 1975-1985 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	activities of daily living functional recovery hemorrhagic stroke ischemic stroke post-acute care rehabilitation Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	activities of daily living functional recovery hemorrhagic stroke ischemic stroke post-acute care rehabilitation Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Chu CL Chen YP Chen CCP Chen CK Chang HN Chang CH Pei YC Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program
description	Chan-Lin Chu,1,2 Yueh-Peng Chen,3 Carl CP Chen,3,4 Chih-Kuang Chen,3,4 Hsiang-Ning Chang,4 Chien-Hung Chang,1,2,5,* Yu-Cheng Pei3,4,6,7,* 1Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 2School of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 4Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 5Department of Electrical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan; 6Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; 7Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan*These authors contributed equally to this workCorrespondence: Yu-Cheng Pei; Chien-Hung Chang Email yspeii@gmail.com; cva9514@gmail.comBackground: Tailored rehabilitation programs for stroke patients cannot be made without knowledge of their recovery potential. The aim of this study is to characterize the functional recovery patterns of ischemic stroke (IS) and intracerebral hemorrhage (ICH) patients under post-acute care stroke rehabilitation.Methods: This retrospective study analyzed the data of patients enrolled in the Post-Acute Care-Cerebrovascular Disease (PAC-CVD) rehabilitation program, which provides an individualized 1- to 3-hour intensive physical, occupational, and speech and language therapy for post-acute stroke patients in Taoyuan Chang Gung Memorial hospital in Taiwan. Our primary endpoint measure was Barthel Index (BI), and secondary endpoint measures included other 12 functional measures.Results: A total of 489 patients were included for analysis. Patients with stroke history had less BI improvement than those who suffered their first-ever stroke. In first-ever stroke patients who had completed 6 to 12 weeks of PAC-CVD program, subcortical ICH patients had greater BI, quality of life, sensation, and balance improvements, and had greater late-phase recovery than their IS counterparts. In IS patients, those with age > 75 had less BI improvement; those with National Institute of Health Stroke Scale (NIHSS) score 1– 5 had greater Motor Activity Log quality of use (MAL-quality) improvement than those with NIHSS score > 5; those with Mini-Mental State Examination (MMSE) score ≥ 24 had greater BI and instrumental activities of daily living (IADL) improvement. Using the general linear model, previous stroke (ß: − 6.148, p=0.01) and subcortical ICH (ß: 5.04, p=0.03) were factors associated with BI improvement.Conclusion: Subcortical ICH patients have greater functional improvement and greater late-phase recovery than their IS counterparts following PAC rehabilitation. More studies are needed to validate our findings and unravel the underlying mechanisms of stroke recovery to optimize the treatment strategy following a stroke.Keywords: activities of daily living, functional recovery, hemorrhagic stroke, ischemic stroke, post-acute care, rehabilitation
format	article
author	Chu CL Chen YP Chen CCP Chen CK Chang HN Chang CH Pei YC
author_facet	Chu CL Chen YP Chen CCP Chen CK Chang HN Chang CH Pei YC
author_sort	Chu CL
title	Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program
title_short	Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program
title_full	Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program
title_fullStr	Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program
title_full_unstemmed	Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program
title_sort	functional recovery patterns of hemorrhagic and ischemic stroke patients under post-acute care rehabilitation program
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/8ad5dad5675344619373428306028974
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Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program

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