Journals / Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi / 2021 / Cilt: 24 - Sayı: 3

Early Intensive Multi-faceted Rehabilitation in Stroke Patients: What is the Best Effective Rehabilitation Time?

İnmeli Hastalarda Erken Yoğun Çok-Yönlü Rehabilitasyon: En Etkili Rehabilitasyon Süresi Nedir?

Pages
267–276
Publication Date
2022-10-18
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Moreover, the start of treatmentwithin the first 9 days provides the most improvement.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: We aimed to evaluate the effects of the intensive and multi-faceted rehabilitation program in patients during the first3 weeks after stroke, and to determine the most effective time to initiatetreatment.
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Key Findings & Data:All patients received a multi-faceted andintensive rehabilitation program 20 sessions in total.
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Conclusion & Impact:Moreover, the start of treatmentwithin the first 9 days provides the most improvement.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: We aimed to evaluate the effects of the intensive and multi-faceted rehabilitation program in patients during the first3 weeks after stroke, and to determine the most effective time to initiatetreatment. Material and Methods: Forty two patients who were treatedin our clinic were included in the study. The demographic characteristics of the patients, the level of stroke severity assessed by the NationalStroke Institute Severity Scale (NIHSS), the functional stages assessedby the Brunstrom and Chedocke McMaster Stroke Assesment (CMSA)Scale and the disability levels assessed by the Functional IndependenceMeasure scale were recorded. All patients received a multi-faceted andintensive rehabilitation program 20 sessions in total. The patients weredivided into 3 groups according to the times of initiation of rehabilitation i.e during the first 9 days (Group 1), between days 10 and 14 (Group2) and between days 15 and 21 (Group 3). The evaluation parameters assessed before the treatment, 4th weeks and 3th months were comparedwithin and between the groups. Results: According to the treatment starttimes; the change in CMMS hand, arm, legand postural control scores,Brunstroom upper, lower limbs and hand levels and the NIHSS scorewas found to be higher in the first 9 days compared to the other 2 groupsin the beginning of treatment. Conclusion: Early intensive and multifaceted rehabilitation program is effective for motor and functional recovery in ischemic stroke patients. Moreover, the start of treatmentwithin the first 9 days provides the most improvement.

Özet

Amaç: Bu çalışma ile inme sonrası ilk 3 hafta içinde uygulanan yoğun ve çok yönlü rehabilitasyon programının hastalardaki etkilerini değerlendirmeyi ve tedaviye başlamak için en etkili zamanı belirlemeyi amaçladık. Gereç ve Yöntemler: Kliniğimizde tedavi gören 42 hasta çalışmaya dâhil edildi. Hastaların demografik özellikleri, Ulusal İnme Enstitüsü Şiddet Ölçeği [National Stroke Institute Severity Scale (NIHSS)] ile değerlendirilen inme şiddeti seviyesi, Brunstrom ve Chedocke McMaster Ölçeği (CMMÖ) ile değerlendirilen fonksiyonel evreler ve Fonksiyonel Bağımsızlık Ölçümü skoru kaydedildi. Tüm hastalara toplamda 20 seans çok yönlü ve yoğun rehabilitasyon programı uygulandı. Hastalar rehabilitasyona başlama zamanlarına göre ilk 9 gün (Grup 1), 10-14 gün (Grup 2) ve 15-21 gün (Grup 3) olarak 3 gruba ayrıldı. Tedavi öncesi, 4. hafta ve 3. ay değerlendirme parametreleri gruplar içi ve gruplar arası karşılaştırıldı. Bulgular: Tedaviye başlama süresine göre; CMMÖ el, kol, bacak ve postüral kontrol skorları, Brunstroom üst, alt ekstremite ve el ve NIHSS skorundaki değişim ilk 9 günde tedaviye alınan grupta diğer 2 gruba göre daha yüksek bulundu. Sonuç: Erken yoğun ve çok yönlü rehabilitasyon programı, iskemik inmeli hastalarda motor ve fonksiyonel iyileşme için etkilidir. Üstelik tedaviye ilk 9 gün içinde başlanması en fazla iyileşmeyi sağlar.

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Cite This Article

ÇAKÇI, F. A., UMAY, E. K., SERÇE, A. (2022). Early Intensive Multi-faceted Rehabilitation in Stroke Patients: What is the Best Effective Rehabilitation Time?. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, Cilt: 24 - Sayı: 3, 267–276. https://ajindex.com/articles/516723

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References (1)

  1. Tomazin R. Task specificity and functional outcome: What is best for post-stroke rehabilitation?. Honors Projects. 2019. [Link] 2. Herisson F, Godard S, Volteau C, et al; SEVEL study group. Early sitting in ischemic stroke patients (SEVEL): A randomized controlled trial. PLoS One. 2016;11:e0149466. [Crossref] [Pubmed] [PMC] 3. Teasell R, Salbach NM, Foley N, et al. Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation following Stroke. Part One: Rehabilitation and Recovery Following Stroke; 6th Edition Update 2019. Int J Stroke. 2020; 15:763-88. [Crossref] [Pubmed] 4. Lynch EA, Cumming T, Janssen H,et al. Early Mobilization after Stroke: Changes in Clinical Opinion Despite an Unchanging Evidence Base. J Stroke Cerebrovasc Dis. 2017;26:1- 6. [Crossref] [Pubmed] 5. Langhorne P, Stott D, Knight A, et al. Very early rehabilitation or intensive telemetry after stroke: a pilot randomised trial. Cerebrovasc Dis. 2010;29:352-60. [Crossref] [Pubmed] 6. Wunderlich MT, Ebert AD, Kratz T, et al. Early neurobehavioral outcome after stroke is related to release of neurobiochemical markers of brain damage. Stroke. 1999;30:1190-5. [Crossref] [Pubmed] 7. Gowland C, Stratford P, Ward M, et al. Measuring physical impairment and disability with the Chedoke-McMaster Stroke Assessment. Stroke. 1993;24:58-63. [Crossref] [Pubmed] 8. Alessandro L, Olmos LE, Bonamico L, et al. Rehabilitación multidisciplinaria para pacientes adultos con accidente cerebrovascular [Multidisciplinary rehabilitation for adult patients with stroke]. Medicina (B Aires). 2020;80:54-68. Spanish. [Pubmed] 9. AVERT Trial Collaboration group. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet. 2015;386(9988):46-55. Erratum in: Lancet. 2015;386(9988):30. Erratum in: Lancet. 2017;389:1884. [Crossref] [Pubmed] 10. Bernhardt J, Churilov L, Dewey H, et al; AVERT Collaborators. Statistical analysis plan (SAP) for A Very Early Rehabilitation Trial (AVERT): an international trial to determine the efficacy and safety of commencing out of bed standing and walking training (very early mobilization) within 24 h of stroke onset vs. usual stroke unit care. Int J Stroke. 2015;10:23-4. [Crossref] [Pubmed] 11. Yen HC, Jeng JS, Chen WS, et al. Early mobilization of mild-moderate intracerebral hemorrhage patients in a stroke center: a randomized controlled trial. Neurorehabil Neural Repair. 2020;34:72-81. [Cr