| Titre : | Effects of a Self-Exercise Program on Activities of Daily Living in Patients After Acute Stroke : A Propensity Score Analysis Based on the Japan Association of Rehabilitation Database (2017) |
| Auteurs : | Nariaki Shiraishi ; Yusuke Suzuki ; Daisuke Matsumoto |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (2017/3, 2017) |
| Article en page(s) : | pp. 434-441 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Accident vasculaire cérébral (AVC) ; Activités de la vie quotidienne ; Rééducation et réadaptation |
| Mots-clés: | Activities of daily living ; Propensity score ; Score de propension ; Stroke |
| Résumé : |
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. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999316309595 |
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