| Titre : | Effectiveness of Home- and Community-Based Rehabilitation in a Large Cohort of Patients Disabled by Cerebrovascular Accident: Evidence of a Dose-Response Relationship (2013) |
| Auteurs : | Irwin M. Altman ; Shannon Swick ; James F. Malec |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (2013/9, 2013) |
| Article en page(s) : | pp. 1837-1841 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Accident vasculaire cérébral (AVC) ; Rééducation et réadaptation |
| Mots-clés: | Stroke |
| Résumé : |
Objectives To (1) assess the effectiveness of home- and community-based rehabilitation (HCBR) in a large cohort of individuals with disabilities secondary to cerebrovascular accident (CVA); and (2) evaluate the responsiveness to treatment of the Mayo-Portland Adaptability Inventory (MPAI-4) to changes resulting from HCBR in this patient group. Design Retrospective analysis of program evaluation data for treatment completers and noncompleters. Setting HCBR conducted in 7 geographically distinct U.S. cities. Participants Individuals with CVA (n=738) who completed the prescribed course of rehabilitation (completed course of treatment [CCT]) compared with 150 individuals who were precipitously discharged (PD) before program completion. Intervention HCBR delivered by certified professional staff on an individualized basis. Main Outcome Measures Mayo-Portland Adaptability Inventory (MPAI-4) completed by professional consensus on admission and at discharge. Results With the use of analysis of covariance, MPAI-4 total scores at discharge for CCT participants were compared with those of PD participants, with admission MPAI-4, age, length of stay, and time since event as covariates. CCT participants showed greater improvement than PD participants (F=99.48, P<.001 with a moderate effect size group differences and sizes were similar for the index scores: ability p partial adjustment participation> Conclusions Individuals in the CCT group who received the entire planned course of HCBR showed greater improvement on all MPAI-4 indexes than those in the PD group who were discharged before completing the prescribed program. This dose-response relationship provides evidence of a causal relationship between treatment and outcome. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |
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