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Auteur Robert L. Askew |
Documents disponibles écrits par cet auteur



Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke / Robert L. Askew in Archives of Physical Medicine and Rehabilitation, Vol. 101, n° 9 (2020)
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[article]
Titre : Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke Type de document : Périodique Auteurs : Robert L. Askew ; Carmen E. Capo-Lugo ; Andrew Naidech ; Shyam K. Prabhakaran Année de publication : 2020 Article en page(s) : p. 1515-1522 Note générale : https://doi.org/10.1016/j.apmr.2020.05.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Abdomen aigu ; Accident vasculaire cérébral (AVC) ; Évaluation des résultats et des processus en soins de santé ; Mesures des résultats rapportés par les patients (PROM) ; Qualité des soins de santé ; Réadaptation ; Rééducation neurologique ; Services de santéRésumé : Objective
To assess the effect of time to acute therapy on health-related quality of life (HRQoL) and disability after ischemic stroke.
Design
Prospective cohort study.
Setting
Comprehensive stroke care center in a large metropolitan city.
Participants
Patients (N=553; mean age, 67 y; 51.9% male; 64.4% white; 88.8% ischemic stroke) with ischemic stroke or transient ischemic attack (TIA) enrolled in a longitudinal observational study between August 2012 to January 2014 who received rehabilitation services.
Intervention
Not applicable.
Main Outcome Measures
Disability status was assessed with the modified Rankin Scale (mRS) and Barthel Index (BI). HRQoL was assessed using the Quality of Life in Neurological Disorders measures of executive function, general cognitive concerns, upper extremity dexterity, and lower extremity mobility. Time to therapy consult and treatment were defined as the number of days from hospital admission to initial consult by a therapist and number of days from hospital admission to initial treatment, respectively.
Results
Among the participants, the median number of days from hospital admission to acute therapy consult was 2 days (interquartile range, 1-3d). Multivariable linear and logistic regression models indicated that for those with the National Institutes of Health Stroke Scale (NIHSS) score Conclusions
Longer time to initiation of acute therapy has differential effects on poststroke disability and HRQoL up to 1-month after ischemic stroke and TIA. The effect of acute therapy consult is more notable for those with mild deficits, while the effect of acute therapy treatment is more notable for those with moderate to severe deficits. Minimizing time to therapy consults and treatments in the acute hospital period might improve outcomes after ischemic stroke and TIA.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259805
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1515-1522[article] Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke [Périodique] / Robert L. Askew ; Carmen E. Capo-Lugo ; Andrew Naidech ; Shyam K. Prabhakaran . - 2020 . - p. 1515-1522.
https://doi.org/10.1016/j.apmr.2020.05.005
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1515-1522
Descripteurs : HE Vinci
Abdomen aigu ; Accident vasculaire cérébral (AVC) ; Évaluation des résultats et des processus en soins de santé ; Mesures des résultats rapportés par les patients (PROM) ; Qualité des soins de santé ; Réadaptation ; Rééducation neurologique ; Services de santéRésumé : Objective
To assess the effect of time to acute therapy on health-related quality of life (HRQoL) and disability after ischemic stroke.
Design
Prospective cohort study.
Setting
Comprehensive stroke care center in a large metropolitan city.
Participants
Patients (N=553; mean age, 67 y; 51.9% male; 64.4% white; 88.8% ischemic stroke) with ischemic stroke or transient ischemic attack (TIA) enrolled in a longitudinal observational study between August 2012 to January 2014 who received rehabilitation services.
Intervention
Not applicable.
Main Outcome Measures
Disability status was assessed with the modified Rankin Scale (mRS) and Barthel Index (BI). HRQoL was assessed using the Quality of Life in Neurological Disorders measures of executive function, general cognitive concerns, upper extremity dexterity, and lower extremity mobility. Time to therapy consult and treatment were defined as the number of days from hospital admission to initial consult by a therapist and number of days from hospital admission to initial treatment, respectively.
Results
Among the participants, the median number of days from hospital admission to acute therapy consult was 2 days (interquartile range, 1-3d). Multivariable linear and logistic regression models indicated that for those with the National Institutes of Health Stroke Scale (NIHSS) score Conclusions
Longer time to initiation of acute therapy has differential effects on poststroke disability and HRQoL up to 1-month after ischemic stroke and TIA. The effect of acute therapy consult is more notable for those with mild deficits, while the effect of acute therapy treatment is more notable for those with moderate to severe deficits. Minimizing time to therapy consults and treatments in the acute hospital period might improve outcomes after ischemic stroke and TIA.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259805 Longer Time Before Acute Rehabilitation Therapy Worsens Disability After Intracerebral Hemorrhage / Carmen E. Capo-Lugo in Archives of Physical Medicine and Rehabilitation, Vol. 101, n° 5 (2020)
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[article]
Titre : Longer Time Before Acute Rehabilitation Therapy Worsens Disability After Intracerebral Hemorrhage Type de document : Article Auteurs : Carmen E. Capo-Lugo ; Robert L. Askew ; Kathryn Muldoon Année de publication : 2020 Article en page(s) : p. 870-876 Note générale : https://doi.org/10.1016/j.apmr.2019.11.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Hemorragie cerebrale ; Réadaptation ; Recherche sur les services de santéRésumé : Objective
Assess the association of time to initiation of acute rehabilitation therapy with disability after intracerebral hemorrhage (ICH) and identify predictors of time to initiation of rehabilitation therapy.
Design
Retrospective data analysis of prospectively collected data from an ongoing observational cohort study.
Setting
Large comprehensive stroke center in a metropolitan area.
Participants
Adults with ICH consecutively admitted (n=203).
Interventions
Not applicable.
Main Outcome Measures
Disability was assessed with the modified Rankin Scale (mRS), with poor outcome defined as mRS 4-6 (dependence or worse). Time to initiation of acute rehabilitation therapy was defined as the number of days between hospital admission and the first consult by any rehabilitation therapy specialist (eg, physical therapy, occupational therapy, speech therapy).
Results
The median number of days from hospital admission to initiation of acute rehabilitation therapy was 3 (range=2-7). Multivariable logistic regression models indicated that each additional day between admission and initiation of acute rehabilitation therapy was associated with increased odds of poor outcome at 30 days (adjusted odds ratio [OR]=1.151; 95% confidence interval [CI]=1.044-1.268; P=.005) and at 90 days (adjusted OR=1.107; 95% CI=1.003-1.222; P=.044) for patients with ICH. A multivariable linear regression model used to identify the predictors of time to initiation of rehabilitation therapy identified heavy drinking (>5 drinks per day), premorbid mRS
Conclusions
Longer time to initiation of acute rehabilitation therapy after ICH may have persistent effects on poststroke disability. Delays in acute rehabilitation therapy consults should be minimized and may improve outcomes after ICH.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=255037
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 870-876[article] Longer Time Before Acute Rehabilitation Therapy Worsens Disability After Intracerebral Hemorrhage [Article] / Carmen E. Capo-Lugo ; Robert L. Askew ; Kathryn Muldoon . - 2020 . - p. 870-876.
https://doi.org/10.1016/j.apmr.2019.11.006
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 870-876
Descripteurs : HE Vinci
Hemorragie cerebrale ; Réadaptation ; Recherche sur les services de santéRésumé : Objective
Assess the association of time to initiation of acute rehabilitation therapy with disability after intracerebral hemorrhage (ICH) and identify predictors of time to initiation of rehabilitation therapy.
Design
Retrospective data analysis of prospectively collected data from an ongoing observational cohort study.
Setting
Large comprehensive stroke center in a metropolitan area.
Participants
Adults with ICH consecutively admitted (n=203).
Interventions
Not applicable.
Main Outcome Measures
Disability was assessed with the modified Rankin Scale (mRS), with poor outcome defined as mRS 4-6 (dependence or worse). Time to initiation of acute rehabilitation therapy was defined as the number of days between hospital admission and the first consult by any rehabilitation therapy specialist (eg, physical therapy, occupational therapy, speech therapy).
Results
The median number of days from hospital admission to initiation of acute rehabilitation therapy was 3 (range=2-7). Multivariable logistic regression models indicated that each additional day between admission and initiation of acute rehabilitation therapy was associated with increased odds of poor outcome at 30 days (adjusted odds ratio [OR]=1.151; 95% confidence interval [CI]=1.044-1.268; P=.005) and at 90 days (adjusted OR=1.107; 95% CI=1.003-1.222; P=.044) for patients with ICH. A multivariable linear regression model used to identify the predictors of time to initiation of rehabilitation therapy identified heavy drinking (>5 drinks per day), premorbid mRS
Conclusions
Longer time to initiation of acute rehabilitation therapy after ICH may have persistent effects on poststroke disability. Delays in acute rehabilitation therapy consults should be minimized and may improve outcomes after ICH.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=255037