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Titre : | Effect of an Evidence-Based Mobility Intervention on the Level of Function in Acute Intracerebral and Subarachnoid Hemorrhagic Stroke Patients on a Neurointensive Care Unit (2015) |
Auteurs : | Maxine L. Rand ; Jeanne A. Darbinian |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2015/7, 2015) |
Article en page(s) : | p. 11911199 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Accident vasculaire cérébral (AVC) ; Durée du séjour ; Mobilité réduite ; Rééducation et réadaptation ; Unités de soins intensifs |
Mots-clés: | Intensive Care Units ; Length of stay ; Mobility limitation ; Stroke ; Subarachnoid hemorrhage ; Hémorragie meningée ; Walking ; Marche à pied |
Résumé : |
Objectives To explore the effect of an evidence-based mobility intervention on the level of function (LOF) achieved by patients with intracerebral hemorrhage (ICH) stroke and subarachnoid hemorrhage (SAH) stroke and to identify clinical characteristics and measures associated with walking distances >15.24m. Design Retrospective pre- and postintervention study. Setting Regional neurointensive care unit. Participants Adult patients with ICH and SAH (N=361). Intervention Daily mobility intervention based on patient's current LOF. Main Outcome Measure Walking >15.24m (LOF 5) by neurointensive care unit discharge. Results Electronic health records for 361 patients (52.6% women; mean age, 62.1y; ICH stroke, 63.2%; aphasia, 35%; hemiplegia, 33%) were included. There was a 2.3-fold increase in patients with hemorrhagic stroke achieving a LOF of 5 by neurointensive care unit discharge after introduction of a mobility intervention. In the multivariable logistic regression model including neurointensive care unit length of stay (LOS) as a covariate, the intervention, LOF of 5 at admission, SAH stroke type, third (vs lowest) quartile of neurointensive care unit LOS, and absence of aphasia and/or hemiplegia were associated with higher likelihood of achieving a LOF of 5 (odds ratio [OR]=5.28; 95% confidence interval [CI], 2.5211.06; OR=6.02; 95% CI, 1.4524.96; OR=3.78; 95% CI, 1.837.80; OR=2.94; 95% CI, 1.167.47; OR=17.77; 95% CI, 6.5947.92, respectively). Conclusions A mobility intervention was strongly associated with increased distance walked by neurointensive care unit patients with acute hemorrhage at discharge and can be applied in any intensive care unit setting to promote stroke recovery. Future studies directed at building predictive models for walking achievement in patients with acute hemorrhagic stroke may provide insight into individualized treatment goal setting and discharge planning. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999315001410 |