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Zemke, Jens. "Das geriatrische Assessment nach Barthel (Barthel-Index, BI)." GGP - Fachzeitschrift für Geriatrische und Gerontologische Pflege 01, no. 03 (October 2017): 117–19. http://dx.doi.org/10.1055/s-0043-110576.
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Zusammenfassung Standardinstrument Assessment nach Barthel Der Barthel-Index wurde als Kontrollparameter der Therapieabläufe in der geriatrischen Medizin entwickelt. Mittlerweile ist er nicht mehr nur ein Instrument des multiprofessionellen geriatrischen Teams, sondern zunehmend auch für die Kostenträger von Behandlung und Rehabilitation. Hier im Fallbeispiel.
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Eakin, Pamela. "The Barthel Index: Confidence Limits." British Journal of Occupational Therapy 56, no. 5 (May 1993): 184–85. http://dx.doi.org/10.1177/030802269305600510.
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Shah and Cooper, in their ‘Commentary’ (BJOT February 1993), state that ‘rehabilitation workers can feel confident in advocating the use of the BI, as modified by Shah et al in 1989, as the preferred measure of ADL’. The evidence they present in their commentary fails to support this assertion.
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Opara, Józef. "Are short forms of Barthel Index equally useful in assessment of ADL?" Rehabilitacja Medyczna 22, no. 2 (October 23, 2018): 40–44. http://dx.doi.org/10.5604/01.3001.0012.6932.
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It has been more than 50 years ago, when in 1965 Florence Mahoney and Dorothea Barthel published an article entitled "Functional evaluation: the Barthel Index." Since then, Barthel scale, also known as a Basic ADL Index (BI), Barthel Score and Maryland Disability Index, is one of the most well-known scales ADL (Activities of Daily Living) and is still popular. This simple scale is still used by the representatives of a number of medical workers for many pur-poses, including the assessment of the results of treatment, rehabilitation, prognosing, assess-ment of self-reliance, assessment of needs for care and for the purposes of the judgment. De-spite its simplicity, the administration of the original Barthel questionnaire takes about 5-10 minutes; that`s why there is a demand for a shortened form of BI. Based on a review of the literature the advantages and disadvantages of the abbreviated BI versions in assessing activities of daily living has been presented. Key Words ADL, Barthel Index, Barthel scale, clinimetrics, short forms Opara J. Are short forms of Barthel Index equally useful in the assessment of ADL? Med Rehabil 2018; 22(2): 40-44. DOI: 10.5604/01.3001.0012.6932
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Mustafa, Kashmala ,., Shoaib Waqas, Rida Khawar Dar, Qurat Ul Ain Sherazi, Muhammad Tariq, and Hafiz M. Asim. "Translation and Validation of Barthel Index in Urdu Language for Stroke Patients." Pakistan Journal of Medical and Health Sciences 16, no. 3 (March 26, 2022): 163–64. http://dx.doi.org/10.53350/pjmhs22163163.
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Aim: To translate and validate of Barthel index in Urdu language for stroke patients Methodology: From June 2020 to January 2021, a descriptive linguistic validation research was done using convenient sampling at Ghurki Trust and Teaching Hospital in Lahore. Twenty neurological rehab professionals and 200 stroke survivors who could understand Urdu were used to validate the content. Two translators, one with a medical background and the other with a technical background in Urdu language, forward translated the BI English version into Urdu. The backward translation of the translated versions BI-Urdu-I and BI-Urdu-II into English was done by two professionals with medical and technical backgrounds who are fluent in Urdu to English translation. After that, the re-translated versions BI-English-III and BI-English-IV were compared to the original BI-English (English version) by expert committee. Data was collected by Final version of Urdu while considering inclusion and exclusion. Patients gave their consent in advance, and anonymity was guaranteed. Results: The mean age of stroke patients was 54.87 and standard deviation was 0.7648. The Chronbach’s alpha of translated version of BI questionnaire is 0.732. The inter item correlation (Pearson Correlation) after testing and re-testing on stroke patients was ranged from (0.425-0.945). The Intra-class Correlation after the translation of BI ranged from 0.314-0.732. Conclusion: Urdu version of Barthel index is a valid and reliable tool for stroke patients. Keywords: Validation, Barthel Index and Stroke
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Negishi, Toshifumi, and Kouichirou Kasahara. "Change in Barthel Index (BI) during Chronic Phase Rehabilitation." KITAKANTO Medical Journal 53, no. 3 (2003): 263–66. http://dx.doi.org/10.2974/kmj.53.263.
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Nicholl, L., J. Hobart, L. Dunwoody, F. Cramp, and A. Lowe-Strong. "Measuring disability in multiple sclerosis: is the Community Dependency Index an improvement on the Barthel Index?" Multiple Sclerosis Journal 10, no. 4 (August 2004): 447–50. http://dx.doi.org/10.1191/1352458504ms1056oa.
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The Community Dependency Index (CDI) was developed due to concerns that the Barthel Index (BI) was limited as a measure of physical function in community settings. However, no studies have compared the two rating scales within multiple sclerosis (MS). The aim of this study was to determine whether, in a community-based sample of people with MS, the CDI is a better measure than the BI. BI and CDI data were collected from 90 people with MS. Four measurement properties were compared: scaling assumptions (item mean scores, corrected item-total correlations), acceptability (score distributions, floor/ceiling effects), reliability (Cronbach’s alpha) and validity (concurrent, discriminant, group differences, relative validity). Both scales satisfied recommended criteria for scaling assumptions (indicating it was legitimate to report a summed score) and internal consistency reliability (alpha-0.85). The scales were highly correlated (r- 0.96), indicating they measured the same construct. Both scales demonstrated good group differences validity, but the BI was marginally superior. Notable ceiling effects (BI-CDI) were demonstrated for both scales, particularly in those less disabled. This study sample had relatively minor levels of disability, with over 70% still being independently mobile. In this sample of people with MS, the measurement properties of the BI and CDI examined were very similar, suggesting the CDI does not appear to have achieved its goal of better measurement.
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Muhammad, Dilshad, Masood Javed, and Ghulam Abbas Sheikh. "ACUTE ISCHEMIC STROKE." Professional Medical Journal 22, no. 03 (March 10, 2015): 276–80. http://dx.doi.org/10.29309/tpmj/2015.22.03.1340.
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Among all deaths, 40-50% are due to vascular events and out of these 10% aredue to stroke. More than 66% of the global stroke occurrence is in developing countries, wherethe average age of patients with stroke is 15 years less than in developed countries. Objectives:To determine the correlation between higher total cholesterol level and high Barthel Indexscore(estimate of functional daily independent activity level) in patients with acute ischemicstroke. Design: Cross sectional study. Period: May 2013 to Apr 2014. Setting: Medical Units ofDHQ and Allied Hospital, Faisalabad. Methodology: Sample size of 200 patients was collectedand patients were included through Consecutive (non-probability) sampling technique. Allpatients underwent CT scan Brain from the radiology department of the hospital to determinethe respective changes (hypo dense area) of the ischemic stroke. Fasting serum cholesterolwas measured in all patients after an overnight fast of 12 hours. Then patients were assessed byusing Barthel Index score (BI). The data was analyzed by using SPSS version 16.0. SpearmanRank correlation coefficient was calculated to BI score in patients with ischemic stroke. Results:The mean age of the patients was noted as 61.76±11.55 years. In this study 55.50% weremales and 44.50% patients were females. The mean total cholesterol value of patients wasnoted as 251.58±71.15 mg/dl. Out of 200 patients, 111(55.5%) patients had high cholesterol(>200mg/dl) whereas 89(44.5%) patient had low cholesterol of(<200mg/dl).In statical analysisthe results showed that the mean value of total Barthel index score was 57.50±19.52. The studyresults described that 51.50% patients had high Barthel index score (>53) whereas 48.50%patients had low Barthel index score (<53). Spearman correlation coefficient was calculatedbetween high TC and high BI score as r= 0.641. This value was statistically significant i.e.p-value=0.000*. Conclusions: With the help of this study, we found a significant positiverelationship between high TC and high BI score in patients presented with ischemic stroke.Now we can better prognosticate the functional outcome of ischemic stroke in our patients.
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Okada, Masahiro, Kazuko Okazaki, Fumiyoshi Murakami, Shinya Okamoto, Hiroki Sugihara, Kengo Banshoya, Tadashi Onoda, Eisuke Takei, Shuso Takeda, and Narumi Sugihara. "Examination of a Short-Term, Prognostic Predictive Method for Terminal Cancer Patients Using the Barthel Index." Reports—Medical Cases, Images, and Videos 3, no. 3 (September 22, 2020): 26. http://dx.doi.org/10.3390/reports3030026.
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For the estimation of short-term prognosis in terminal cancer patients, it is important to establish a prognostic index that does not involve blood tests. We compared the prognostic ability of the Barthel Index (BI) with the Glasgow Prognostic Score (GPS). Ninety-seven inpatients with terminal cancer at Onomichi Municipal Hospital who died between 2018 and 2019 were retrospectively analyzed. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUROC) were compared between the BI and GPS. For predicting the 15 day prognosis, the BI showed higher specificity, accuracy, and AUROC than the GPS. For predicting the 30 day prognosis, the BI showed higher sensitivity, accuracy, and AUROC than the GPS. The BI can predict the 15 or 30 day prognosis in terminal cancer patients. As the BI does not require blood tests, it may be an option for prognostic prediction in terminal cancer patients.
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Jakavonytė-Akstinienė, Agnė, Vytautas Dikčius, and Jūratė Macijauskienė. "Prognosis of treatment outcomes by cognitive and physical scales." Open Medicine 13, no. 1 (March 21, 2018): 74–82. http://dx.doi.org/10.1515/med-2018-0011.
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AbstractThe aim of this study was to assess the possibility of using scales for measuring cognitive and physical functions for a prognosis of care outcomes in elderly patients. Methodology. The survey was carried out in one of the Vilnius City Hospitals for Nursing and Support Treatment. A total number of 177 respondents were involved in the study. The Mini–Mental State Examination (MMSE), The Barthel Index (BI) and The Morse Fall Scale were used. Results. A statistically significant correlation was revealed between the scores of MMSE and BI (Pearson R = 0.41, p < 0.01); those with severe cognitive impairment were more dependent. A statistically significant correlation (Pearson R = −0.181, p < 0.01) was reported between the scores of MMSE and the Morse Fall Scale – the risk of falling was higher in patients with severe cognitive impairment. Conclusions. The Morse Fall Scale was not suitable for the prognosis of outcomes. The MMSE was suitable for the prognosis of a patient’s discharge. The Barthel Index should be considered as the most suitable tool for the prognosis of care outcomes: the sum-score of the Barthel Index above 25 may suggest that the patient would be discharged home; the sum-score below this level was associated with a higher likelihood of patient death.
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Hale, L. A., C. J. Eales, and V. U. Fritz. "The Soweto stroke questionnaire." South African Journal of Physiotherapy 54, no. 4 (November 30, 1998): 16–20. http://dx.doi.org/10.4102/sajp.v54i4.584.
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A questionnaire was designed for a recent survey into the outcome of stroke patients in Soweto, named the Soweto Stroke Questionnaire (SSQ). It was based on the Barthel ADL Index (BI) but modified to suit the local context. This paper introduces the SSQ, and reports on its inter-rater reliability and its concurrent validity. Fifty-four subjects, in the age range 30 to 75 years, were interviewed and nineteen re-interviewed using the SSQ. Four different scores were calculated: a total score, a Barthel Index score, an Impairment score, and a Quality of Life score. The Pearson’s Correlation Coefficient was found to be high between the total score and the BI score. (r=0.948) which supports the concurrent validity of the developed questionnaire. In assessing the reliability of the SQQ, the Wilcoxin Test showed that there was no significant difference between the initial and repeat interviews for the total score, the Barthel Index score, and the Impairment score (p<0,05). The Quality of Life Score came closer to a difference, but not statistically significantly so. These tests were collaborated by Bland and Altman graphs which showed that in 95% of the time, the questions were repeatable. Mc Nemar’s Test of Symmetry showed that 34 out of 38 questions asked were found to have over 70% correlation. Four questions showed a lower correlation, the lowest being 63.16%. The SSQ was found to have interrater reliability, and to be concurrently valid to the Barthel Index. It is quick and easy to use, requiring no sophisticated equipment or training. It still requires to be investigated for sensitivity and predictiveness, and to be validated in a more general South African stroke population.
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石娉雯, 石娉雯, 王肇 王肇, 王雅君 王雅君, 楊雅惠 Ya-June Wang, 蔡瑞修 Ya-Hui Yang, and 吳信昇 吳信昇. "利用貝氏量表評估台灣長期照護之男性老年居民的營養不良風險." 輔仁醫學期刊 20, no. 4 (December 2022): 014–22. http://dx.doi.org/10.53106/181020932022122004002.
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<p>目的：營養不良是老年中常見的健康問題。在台灣，老年人必須在巴氏量表（BI）達到90分以上，才有資格申請入護理機構；但是，不需要有營養評估。本研究的目的是當老年人要求轉診護理機構時，是否可以以BI去評估營養狀況。方法：這是一個多中心的橫斷式研究。在2010年11月至2011年5月之間對台灣三個療養院的居民進行評估。其中包括251位年齡在70歲以上的個案。我們收集了個案的背景資料、BI評分、迷你營養評估以及調查牙齒健康和吞嚥能力的問卷。結果：平均年齡和BI評分分別為82.9（SD5.6）和88.8（SD21.7）。在研究樣本中，確定有營養不良風險的個案為123名（49.0％）。在預測營養不良的風險上，BI有高度的準確性（ROC曲線為79.1％）。較低的BI分數與較高的營養不良風險相關。所有BI項目中，爬樓梯項目與營養狀況之間的相關性最強（Cohen：0.90），其次是活動能力和輪椅到床的移動（ES：0.76）。結論：我們強調早期預防老年營養不良是相當重要。本研究顯示，BI可以協助初步評估營養狀況。</p> <p> </p><p>Objective: Malnutrition is a common health concern among the older population. In Taiwan, older adults are required to score 90 or higher on the Barthel Index (BI) to qualify for admission to public long-term care institutions; however, they are not ob-ligated to undergo nutritional assessments. This study demonstrated the utility of the BI in determining nutritional status when older adults are referred to public long-term institutions. Methods: In this multicentre cross-sectional study, 251 residents aged 70 years or older at three nursing homes in Taiwan were evaluated between November 2010 and May 2011. Information on participants’ health history was collected, in-cluding BI scores, Mini Nutritional Assessment results, and previous responses to a questionnaire on dental health and swallowing capacity. Results: The mean age and BI score were 82.9 (SD 5.6) and 88.8 (SD 21.7), respectively. Among the study sample, 123 (49.0%) participants were identified as having a risk of malnutrition. The BI had high accuracy (area under the receiver operating characteristic curve, 79.1%) when used to predict the risk of malnutrition. Lower BI scores were associated with a higher risk of malnutrition. Of all BI items, the stair-climbing item had the highest correlation with nutritional status (Cohen’s standardised effect size [ES]: 0.90), followed by mobility and chair–bed transfers (both ESs: 0.76). Conclusion: We emphasise that preventing worsening malnutrition in older long-term care residents is crucial. The present study revealed that the BI can help with the primary assessment of nutritional status in older adult men, although it cannot be a decisive tool by itself for nutritional status assessment.</p> <p> </p>
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Aguilar-Zafra, Sandra, Tamara del Corral, Juan Antonio Valera-Calero, Patricia Martín-Casas, Gustavo Plaza-Manzano, and Ibai López-de-Uralde-Villanueva. "Development of the Web-Based Spanish Version of the Barthel Index in Patients with Multiple Sclerosis." International Journal of Environmental Research and Public Health 19, no. 21 (October 27, 2022): 13965. http://dx.doi.org/10.3390/ijerph192113965.
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Background: The aims of this study were to develop a web-based Spanish form of the Barthel index (BI), to evaluate its psychometric properties and stability over time (test-retest), and to determine minimal detectable change (MDC) in patients with multiple sclerosis (MS). Methods: Participants answered the BI on two forms (web-based and face-to-face interview), 7–10 days apart. The internal consistency was evaluated using Cronbach’s alpha, and intraclass correlation (ICC) and kappa (κ) coefficients were used to investigate the agreement between both forms. Results: 143 participants were included. The Spanish web-based form of the BI showed excellent agreement between both forms for each item (κ = 0.86 (0.79 to 0.92), and for total score (κ = 0.87 (0.81 to 0.93); ICC = 0.99 (0.98 to 0.99). The internal consistency was good–excellent (Cronbach’s alpha = 0.89 (0.86–0.91)). The stability over time was adequate, the agreement of each item was κ = 0.63 (0.52–0.74)), and for total score (ICC = 0.97), determining a MDC95 of 12.09 points. Conclusions: The Spanish web-based form of the BI is a valid and reliable tool to assess functionality and can be applied in both formats in patients with MS. A total score difference of more than 12 points was found to indicate a deterioration or improvement in the patient’s functionality.
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Zheng, Xingzhen, Haidong Wang, and Xiaolin Bian. "Clinical Correlation Analysis of Complications in Elderly Patients with Sequelae of Stroke with Different Barthel Index in Tianjin Emergency Department." BioMed Research International 2021 (January 22, 2021): 1–6. http://dx.doi.org/10.1155/2021/6625440.
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Objective. The Barthel index (BI) is the most commonly used measure of poststroke disability. The purpose of this article is to explore the different complications and severity of the sequelae of elderly stroke patients with different BI in the emergency department, so as to provide a theoretical basis for strengthening the treatment of elderly patients with stroke sequelae. Methods. A retrospective study was adopted, and 1896 patients were divided into two groups according to the BI: 823 patients in the bedridden group ( BI ≤ 40 points ) and 1073 patients in the nonbedridden group ( BI > 40 points ). The type and number of complications and APACHE II score were compared between the two groups. Results. Compared with the two groups, pneumonia, renal insufficiency, respiratory failure, and decubitus ulcer in the bedridden group had a higher incidence, but the incidence of upper gastrointestinal bleeding and fractures in the nonbedridden group was significantly higher ( P < 0.05 ). The APACHE II score of the patients in the bedridden group was higher than that of the nonbedridden group, and they were critical ( P < 0.001 ). And the number of complications was higher than that in the nonbedridden group. Moreover, the BI was negatively correlated with the APACHE-II score and the number of complications, and the APACHE II score was positively correlated with the number of complications ( P < 0.001 ). Conclusion. Different complications and severity of illness occur in elderly patients with sequelae of stroke after different BI in the emergency department.
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Kaambwa, Billingsley, Norma B. Bulamu, Christine Mpundu-Kaambwa, and Raymond Oppong. "Convergent and Discriminant Validity of the Barthel Index and the EQ-5D-3L When Used on Older People in a Rehabilitation Setting." International Journal of Environmental Research and Public Health 18, no. 19 (September 30, 2021): 10314. http://dx.doi.org/10.3390/ijerph181910314.
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This study compares the empirical performance of a commonly used functional-status measure, the Barthel Index (BI), to that of a widely used generic preference-based instrument, the EuroQoL-5-Dimensions 3 Level (EQ-5D-3L), in older people. Data from older people receiving rehabilitation services were used to test the validity of the BI and EQ-5D-3L. Convergent validity was investigated using Spearman’s correlation, exploratory factor analysis (EFA), scatter plots, Krippendorff’s alpha and modified Bland-Altman plots. Discriminant validity was examined using Kruskal Wallis tests, ceiling effects and EFA. A total of 1690 participants were included in the analysis. The BI total and EQ-5D-3L utility scores showed moderate correlation (r = 0.51; Krippendorff’s alpha = 0.52). Kendall’s Tau-B correlations between BI items and EQ-5D-3L dimensions measuring the same construct were weak to moderate (0.05 ≤ absolute r ≤ 0.54). In the EFA, some BI items cross-loaded onto the same factors as EQ-5D-3L dimensions, suggesting that the instruments were interrelated. The BI, however, focuses more on physical functioning, while the EQ-5D-3L measures broader wellbeing concepts. Both instruments showed good discriminant validity and would therefore be equally valuable for measuring subgroup differences. Researchers should consider using the BI in rehabilitation to capture more physical functioning-specific constructs not measured by the EQ-5D-3L.
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Tanovic, Edina, Dževad Vrabac, Aldijana Kadić, Admir Rama, and Haris Tanović. "Evaluation of the treatment efficacy of patients with multiple sclerosis using Barthel index and Expanded Disability Status Scale." Journal of Health Sciences 4, no. 2 (September 26, 2014): 110–13. http://dx.doi.org/10.17532/jhsci.2014.202.
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Introduction: Multiple sclerosis (MS) is a chronic, autoimmune and progressive multifocal demyelinating disease of the central nervous system. The aim of this study was to evaluate rehabilitation of patients with multiple sclerosis using BI (Barthel index) and EDDS (Expanded Disability Status Scale).Methods: A clinical observational study was made at the clinic for physical medicine and rehabilitation in Sarajevo. We analyzed 49 patients with MS in relation of gender, age and level of disability at admission and discharge, patient disability were estimated using EDDS scale. The ability of patients in their activities of daily living were also analyzed according to the BI at admission and discharge.Results: Of the total number of patients (n=49) there were 15 men and 34 women. The average age of female patient was 42.38±13.48 and male patient 46.06±9.56. EDDS values were significantly different at the beginning and at the end of the therapy (p=0.001) as was the value of BI (p=0.001).Conclusion: MS patients, after the rehabilitation in hospital conditions show significant recovery and a reduced level of disability; they show higher independence in activities but rehabilitation demands individual approach and adjustment with what patients are currently capable of achieving.
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Saito, N., and T. Nshikawa. "The effect of high blood pressure (HBP) on total Barthel Index (BI) and 10 items of BI after stroke rehabilitation." Annals of Physical and Rehabilitation Medicine 61 (July 2018): e211. http://dx.doi.org/10.1016/j.rehab.2018.05.488.
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Wojzischke, Julia, Jürgen M. Bauer, Andreas Hein, and Rebecca Diekmann. "The Relevance of Obesity for Activities of Daily Living in Geriatric Rehabilitation Patients." Nutrients 13, no. 7 (July 1, 2021): 2292. http://dx.doi.org/10.3390/nu13072292.
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The obesity pandemic has reached old age but the effect of obesity on functional recovery in geriatric rehabilitation patients has not been investigated to date. In this prospective cohort study, patients admitted into geriatric rehabilitation were consecutively included between September 2015 and September 2016, aged ≥70 years. Individual activities of daily living were documented by the Barthel index (BI, 0–100 points). Obesity was assessed by the measurement of body mass index (BMI, kg/m²), waist circumference (WC, cm) and percentage of body fat mass (%FM) based on triceps’ skinfold thickness at admission (t1), discharge (t2) and six months after discharge (t3). A total of 122 patients were included in the analysis. Prevalence of obesity according to BMI, WC and %FM was 33.6%, 83.6% and 71.3% respectively. Patients with a high WC and patients with a high BMI had lower BI values at t1, t2, t3 and the improvement in BI (t1–t2, t2–t3) was lower than in those with low WC and low BMI, but without statistical significance. In multiple regression analysis, BMI, WC and %FM were not associated with BI at t3 and improvement of BI (t2–t3). Obesity was highly prevalent in geriatric rehabilitation patients, but it was not associated with BI during the 6-month follow-up.
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Kuwabara, Kazuaki, Shinya Matsuda, Koichi Benjamin Ishikawa, Hiromasa Horiguchi, and Kenji Fujimori. "Comparative Quality of Laparoscopic and Open Cholecystectomy in the Elderly Using Propensity Score Matching Analysis." Gastroenterology Research and Practice 2010 (2010): 1–10. http://dx.doi.org/10.1155/2010/490147.
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The safety of laparoscopic cholecystectomy (LC) in patients ≥65 years of age requires further investigation of postoperative outcomes before it becomes more widely accepted as a safe technique. The advantages of using LC versus open cholecystectomy (OC) in elderly patients were analyzed using propensity score matching. The demographics, cholecystitis severity, comorbidities, complications, and admission and discharge Barthel Index (BI) scores of patients with benign gallbladder diseases were analyzed. Outcomes were analyzed by age, length of stay (LOS), total charges (TCs), BI improvement, and postoperative complications. OC, which was indicated in severe disease cases, increased hospital resource use and caused more complications than LC, but did not improve BI. Advanced age and OC resulted in greater LOS and TCs and was the best indicator of BI deterioration. Whenever possible, surgeons should use LC in elderly patients to minimize postoperative complications and allow them to regain a good quality of life.
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Couto, Marcela de Abreu Silva, Rodrigo Reiff, and Alessandra Paiva de Castro. "Functionality after hip surgery: correlation between balance, age, independence, and depression among the elderly." Acta Fisiátrica 19, no. 1 (March 9, 2012): 32–36. http://dx.doi.org/10.11606/issn.2317-0190.v19i1a103678.
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Objective: To determine correlations between age and balance, independence, and depression among the elderly who suffered hip fractures following a fall. Method: The consecutive sample included elderly who had suffered hip fractures within the past 24 months. We evaluated 14 elderly patients (12 women and two men); with an average age of 78 ± 6.9 years old. A questionnaire was applied to obtain general data, Timed Up and Go (TUG test), Berg Balance Scale (BBS), Geriatric Depression Scale - Short form (GDS-S), Barthel Index (BI), and Waist-hip ratio (WHR). We used the one-way ANOVA, t-test, and Pearson correlation tests with a significance levels of 5%. Results: Mean tests: BBS (35.38 ± 33.06), the TUG test (28.40 ± 10.59), the pre-fall GDS-S 6.33 ± 1.52, the post-fall GDS-S 7.66 ± 1.52, and the WHR 1.05 ± 0.35 for men and 0.92 ± 0.12 for women. The Barthel Index pre-fall was 16.20 ± 5.4 and the Barthel Index post-fall was 15.12 ± 6.78. The greater the age, the longer the stay, but there was no correlation between age and function. There was a negative correlation between age and balance, but age was not related to the level of depression. Conclusion: A positive correlation was found between age and length of stay and a negative correlation was found between age and balance. There was a decrease in the BBS, and an increase in the length of the TUG test and WHR.
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Siotto, Mariacristina, Marco Germanotta, Massimo Santoro, Chiara Di Blasi, Claudia Loreti, Simona Mastropaolo, and Irene Aprile. "Total Serum Calcium and Recovery after Rehabilitation in Patients with Stroke." Applied Sciences 10, no. 21 (November 7, 2020): 7893. http://dx.doi.org/10.3390/app10217893.
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Calcium deficiency is frequently observed in stroke survivors, but no data exist concerning the relationship between calcium and rehabilitation outcome in patients with stroke. Therefore, we examined in a group of subacute stroke patients if changes in the Barthel Index after a rehabilitation treatment were associated with blood parameters related to calcium status. We retrospectively explored serum calcium status (total calcium, ionized calcium), serum total protein status, and serum albumin percentage in 30 subacute stroke patients admitted to our rehabilitation center. Patients underwent a 6-week rehabilitation treatment (each session lasting 45 min, 2 sessions/day, 6 days/week). Overall, 26.7% of patients had total calcium levels below the reference range, whereas 100% of patients had ionized calcium in the reference range. Total protein and albumin were below the reference range in about 77% and 67% of patients, respectively. We found that only total calcium was correlated with the change from baseline of the Barthel Index (BI) (rho = 0.466, p = 0.009). A multiple linear regression model confirmed that in our sample the total calcium significantly predicted the change from baseline of the Barthel Index (F5, 24 = 4.074, p = 0.008, adj. R2 = 0.346). This study suggests a possible connection between serum calcium status and total protein status of stroke patients undergoing rehabilitation treatment and rehabilitation outcomes. Further investigations are necessary to confirm the importance of testing serum calcium status of patients at admission in a rehabilitation unit for an eventual supplementation or a dietary personalized program.
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Tan, Adrian KH, Rangpa Taiju, Edward B. Menon, and Gerald CH Koh. "Postoperated Hip Fracture Rehabilitation Effectiveness and Efficiency in a Community Hospital." Annals of the Academy of Medicine, Singapore 43, no. 4 (April 15, 2014): 209–15. http://dx.doi.org/10.47102/annals-acadmedsg.v43n4p209.
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Introduction: This study aims to determine the inpatient rehabilitation effectiveness (REs) and rehabilitation efficiency (REy) of hip fracture in a Singapore community hospital (CH), its association with socio-demographic variables, medical comorbidities and admission Shah-modified Barthel Index (BI) score as well as change in independent ambulation from discharge to 4 months later. Materials and Methods: A retrospective cohort study using data manually extracted from medical records of all patients who had hip fracture within 90 days and admitted to a CH after the operation for rehabilitation. Multiple linear regressions are used to identify independent predictors of REs and REy. Results: The mean REs was 40.4% (95% Confidence Interval (CI), 36.7 to 44.0). The independent predictors of poorer REs on multivariate analysis were older age, Malay (vs non-Malay) patients, fewer numbers of rehabilitative therapy sessions and dementia. The mean REy was 0.41 units per day [CI, 0.36 to 0.46]. The independent predictors of poorer REy on multivariate analysis were higher admission BI and being non-hypertensive patient. The prevalence of independent ambulation improved from 78.9% at the discharge to 88.3% 4 months later. Conclusion: CH inpatient rehabilitative therapy showed REs 40.4% and REy of 0.41 units per day and the optimum number of rehabilitative therapy session was from 28 to 41 in terms of rehabilitation effectiveness and the maximum rehabilitation efficiency was seen in those doing 14 to 27 sessions of rehabilitative therapy. The study also showed improvement in BI at discharge and improvement in the independent ambulation 4 months after discharge from the CH. Key words: Modified Barthel Index, Length of stay, Length of weight bearing
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Nikolic, Igor, Dragoslav Nestorovic, Nikola Repac, Sasa Knezevic, and Goran Tasic. "Intrathecal baclofen therapy and Covid-19 infection - report of three cases." Srpski arhiv za celokupno lekarstvo, no. 00 (2022): 76. http://dx.doi.org/10.2298/sarh211222076n.
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Introduction. Patients with severe spasticity are effectively treated with intrathecal baclofen therapy (ITB), but because of their invalidity, in case of infection, prognosis is poor. Case outline. We present three cases (two men and one woman) of patients treated with baclofen intrathecal therapy due to spasticity of all four extremities who underwent SARS-CoV2 virus infection. Two of them have multiple sclerosis, and one has trauma of the cervical segment of the spinal cord. In all three patients, the clinical presentation of Covid-19 infection occurred within six months of implantation of the pump for ITB. They were successfully treated in hospital with same dose of the drug and without exacerbation of neurological status. Barthel index and modified Rankin score were same before and after Covid-19 infection. In two cases Barthel index (BI) was 20, and in one 69; and modified Rankin score (mRS) was 3 in one case, and 5 in two cases. Conclusion. Patients with severe spasticity who require intrathecal baclofen therapy can be safely treated regardless of the pandemic.
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Saha, Sujan, Md Tanvir Islam, Md Shamsul Ahsan, and Md Moniruzzaman. "Validation of Bengali Modified Barthel Index in aged patients of Bangladesh." Asian Journal of Medical and Biological Research 7, no. 3 (September 30, 2021): 238–48. http://dx.doi.org/10.3329/ajmbr.v7i3.56134.
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Functional independence is an integral part for reflection of quality of living. Many scales have been utilised for it and the Barthel Index (BI) is one of them, which later modified on 10 activities having the score range of 0-20. English version of the Modified Barthel Index (MBI) is widely used to measure disability also in Bangladesh and an important tool for assessment of activities of daily living in aged patients. However, a validated and culturally adapted Bengali version of MBI has not been produced yet. This study describes the validation and reliability into Bengali of the modified 10-item version of MBI, and reports the procedures for testing its validity and reliability. For validation process a two phased study was conducted based on data from aged patients in out and in patient department of Bangabandhu Sheikh Mujib Medical University. After pre-testing of the Bengali version of MBI (B-MBI) among 30 aged patients in phase-1 of the study whereas total 129 patients were submitted to the adapted scale for testing its acceptability and internal consistency in second phase. The internal consistency by Cronbach’s alpha resulted equal to 0.880. The score was also tested against the Bengali adapted SF-36 (Short Form-36) to compare with physical functioning and mental health domains. It yielded Spearman’s correlation coefficient (rS) 0.787 (p<0.001)), indicating strong positive correlation of B-MBI with physical functioning part and a weak correlation (rs=0.191; p=0.031) was found with mental health domain of SF-36. Reliability was evaluated on 124 cases as 5 participants were missed for re-test; at test-retest was ICC=0.961 (95%IC: p<0.001). This study provides a new tool for professionals in Bangladesh to measure functional disability in aged patients both in inpatient and outpatient department of hospitals and also in the health and social care settings along the continuum of care. Asian J. Med. Biol. Res. 2021, 7 (3), 238-248
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Fujimoto, Yusuke, Takao Setoguchi, Yasuhiro Ishidou, and Noboru Taniguchi. "Low geriatric nutritional risk index is a risk factor for death within 1 year following hip fracture." Journal of Orthopaedic Surgery 30, no. 2 (January 2022): 102255362211033. http://dx.doi.org/10.1177/10225536221103360.
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Purpose Hip fracture is common in older patients and is associated with high mortality and functional impairment. The Geriatric Nutritional Risk Index (GNRI) evaluates the risk of malnutrition-related complications, and the Barthel Index (BI) evaluates older patients’ functional status. The study aim was to determine the risk factors for both death and decreased BI within 1 year after hip fracture. Methods We retrospectively reviewed the records of 108 patients who were treated for hip fractures in 10 public or private hospitals from February to July 2007. Participating facilities comprised eight public or private hospitals with 200–499 beds, and two private or orthopedic hospitals with 20–199 beds. We evaluated several risk factors for death and lower BI within 1 year after hip fracture. Results The mortality rate within 1 year postoperatively for patients who survived inpatient stay was 6.5% (7/108). The proportion of patients with decreased postoperative BI was 43.6% (44/101). Binomial logistic regression analysis showed that several factors, including low GNRI (odds ratio [OR]: 0.80; 95% confidence interval [CI: 0.68–0.93]), were risk factors for death within 1 year. Postoperative delirium (OR: 8.84 [1.52–51.6]), postinjury dementia (OR: 34.8 [3.01–402]), preinjury BI (OR: 1.05 [1.02–1.08]), and preinjury dementia (OR: 6.22 [1.73–22.4]) were risk factors for decreased postoperative BI. Conclusions Our findings indicated that lower GNRI was a risk factor for death within 1 year of hip surgery and that delirium and dementia were among the risk factors for decreased BI 1 year after hip fracture.
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Rangaraju, Srikant, Diogo Haussen, Raul G. Nogueira, Fadi Nahab, and Michael Frankel. "Comparison of 3-Month Stroke Disability and Quality of Life across Modified Rankin Scale Categories." Interventional Neurology 6, no. 1-2 (November 16, 2016): 36–41. http://dx.doi.org/10.1159/000452634.
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Background and Purpose: Modified Rankin Scale (mRS) score 0-2 has been used to define “good outcome” while stroke patients with mRS 3 are grouped with mRS 4-6 as having “poor outcome.” Long-term data comparing quality of life (QoL), particularly across the mRS 2, 3, and 4 subgroups, are sparse. Methods: Participants in the Interventional Management of Stroke 3 (IMS3) trial with documented 3-month mRS, functional disability (Barthel index [BI]), and self-reported EQ5D-3L QoL questionnaires at 3 months after stroke were included. EQ5D-3L summary indices were calculated using published utility weights for the US population. BI and EQ5D-3L indices were compared across mRS categories using multiple pairwise comparisons with appropriate alpha error corrections. Results: Four hundred twenty-three patients were included (mean age 64 ± 13 years, median baseline NIHSS 16 [IQR 12-19], mean BI 84.1 ± 25.3, and mean EQ5D-3L index 0.73 ± 0.24). While significant differences in BI were observed across mRS categories, QoL in the mRS 2 and 3 categories was similar. Based on BI and EQ5D-3L index, mRS 3 status was more similar to mRS 2 than to mRS 4 status, and large heterogeneity in the mRS 3 group was observed. Conclusions: Ischemic stroke patients who achieve mRS 2 and 3 functional outcomes seem to have similar health-related QoL scores. mRS 0-3, rather than 0-2, should be considered a good outcome category in moderate to severe ischemic stroke.
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Liu, Wei, Chang Rao, Yuzheng Du, Lili Zhang, and Jipeng Yang. "The Effectiveness and Safety of Manual Acupuncture Therapy in Patients with Poststroke Cognitive Impairment: A Meta-analysis." Neural Plasticity 2020 (November 24, 2020): 1–15. http://dx.doi.org/10.1155/2020/8890521.
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Background. Poststroke cognitive impairment (PSCI) is a common cause of disability among patients with stroke. Meanwhile, acupuncture has increasingly been used to improve motor and cognitive function for stroke patients. The aim of the present study was to summarize and evaluate the evidence on the effectiveness of acupuncture in treating PSCI. Methods. Eight databases (PubMed, The Cochrane Library, CNKI, WanFang Data, VIP, CBM, Medline, Embase databases) were searched from January 2010 to January 2020. Meta-analyses were conducted for the eligible randomized controlled trials (RCTs). Assessments were performed using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Barthel Index (BI), or modified Barthel Index (MBI). Results. A total of 657 relevant RCTs were identified, and 22 RCTs with 1856 patients were eventually included. Meta-analysis showed that acupuncture appeared to be effective for improving cognitive function as assessed by MMSE ( mean difference MD = 1.73 , 95% confidence interval (CI) (1.39, 2.06), P < 0.00001 ) and MoCA ( MD = 2.32 , 95% CI (1.92, 2.73), P < 0.00001 ). Furthermore, it also suggested that acupuncture could improve the activities of daily life (ADL) for PSCI patients as assessed by BI or MBI ( SMD = 0.97 , 95% CI (0.57, 1.38), P < 0.00001 ). Conclusions. Compared with nonacupuncture group, acupuncture group showed better effects in improving the scores of MMSE, MoCA, BI, and MBI. This meta-analysis provided positive evidence that acupuncture may be effective in improving cognitive function and activities of daily life for PSCI patients. Meanwhile, long retention time of acupuncture may improve cognitive function and activities of daily life, and twist technique may be an important factor that could influence cognitive function. However, further studies using large samples and a rigorous study design are needed to confirm the role of acupuncture in the treatment of PSCI.
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Cebrià i Iranzo, Maria A., Anna Arnal-Gómez, Maria A. Tortosa-Chuliá, Mercè Balasch-Bernat, Silvia Forcano, Trinidad Sentandreu-Mañó, Jose M. Tomas, and Natalia Cezón-Serrano. "Functional and Clinical Characteristics for Predicting Sarcopenia in Institutionalised Older Adults: Identifying Tools for Clinical Screening." International Journal of Environmental Research and Public Health 17, no. 12 (June 22, 2020): 4483. http://dx.doi.org/10.3390/ijerph17124483.
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Background: Recently, the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated the sarcopenia definition based on objective evaluation of muscle strength, mass and physical performance. The aim of this study was to analyse the relationship between sarcopenia and clinical aspects such as functionality, comorbidity, polypharmacy, hospitalisations and falls in order to support sarcopenia screening in institutionalised older adults, as well as to estimate the prevalence of sarcopenia in this population using the EWGSOP2 new algorithm. Methods: A multicentre cross-sectional study was conducted on institutionalised older adults (n = 132, 77.7% female, mean age 82 years). Application of the EWGSOP2 algorithm consisted of the SARC-F questionnaire, handgrip strength (HG), appendicular skeletal muscle mass index (ASMI) and Short Physical Performance Battery (SPPB). Clinical study variables were: Barthel Index (BI), Abbreviated Charlson’s Comorbidity Index (ACCI), number of medications, hospital stays and falls. Results: Age, BI and ACCI were shown to be predictors of the EWGSOP2 sarcopenia definition (Nagelkerke’s R-square = 0.34), highlighting the ACCI. Sarcopenia was more prevalent in older adults aged over 85 (p = 0.005), but no differences were found according to gender (p = 0.512). Conclusion: BI and the ACCI can be considered predictors that guide healthcare professionals in early sarcopenia identification and therapeutic approach.
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Gerreth, Piotr, Karolina Gerreth, Mateusz Maciejczyk, Anna Zalewska, and Katarzyna Hojan. "Is an Oral Health Status a Predictor of Functional Improvement in Ischemic Stroke Patients Undergoing Comprehensive Rehabilitation Treatment?" Brain Sciences 11, no. 3 (March 7, 2021): 338. http://dx.doi.org/10.3390/brainsci11030338.
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The study’s aim was a clinical observation concerning the influence of oral health on functional status in stroke patients undergoing neurorehabilitation. This pilot cross-sectional clinical study was performed in 60 subacute phase stroke patients during 12 weeks of treatment. The program was patient-specific and consisted of neurodevelopmental treatment by a comprehensive rehabilitation team. The functional assessment was performed using the Barthel index (BI), Berg balance scale (BBS), functional independence measure (FIM), and Addenbrooke’s cognitive examination III (ACE III) scales. Oral health was assessed according to World Health Organization (WHO) criteria, and it was presented using DMFT, DMFS, gingival index (GI), and plaque index (PlI). Significant improvement in many functional scales was noticed. However, important differences in most dental parameters without relevant changes in GI and PlI after the study were not observed. Reverse interdependence (p < 0.05) was shown between physical functioning (BI, FIM, or BBS) with GI and PlI results, and most dental parameters correlated with ACE III. Using multivariate regression analysis, we showed that ACE III and BI are predictive variables for DMFT, just as FIM is for DS (p < 0.05). The present research revealed that poor oral health status in patients after stroke might be associated with inpatient rehabilitation results.
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Kimura, Atsushi, Yoshihiro Matsumoto, Yoshifumi Wakata, Akiko Oyamada, Masanobu Ohishi, Toshifumi Fujiwara, Ko Ikuta, et al. "Predictive factors of mortality of patients with fragility hip fractures at 1 year after discharge: A multicenter, retrospective study in the northern Kyushu district of Japan." Journal of Orthopaedic Surgery 27, no. 3 (August 29, 2019): 230949901986696. http://dx.doi.org/10.1177/2309499019866965.
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Purpose: Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan. Methods: A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models. Results: The 1-year mortality rate was 9.1% (95% confidence interval: 6.8–12.0%, n = 45). Log-rank test revealed that previous fractures ( p = 0.003), Barthel index (BI) at discharge ( p = 0.011), and place-to-discharge ( p = 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; p = 0.023), total Charlson comorbidity index (TCCI; p = 0.005), smoking ( p = 0.007), length of hospital stay (LOS; p = 0.009), and BI ( p = 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; p = 0.044), and BI <30 (HR 5.42, p = 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m2 (HR 2.70, p = 0.023), TCCI ≥5 (HR 2.61, p = 0.032), smoking history (HR 3.59, p = 0.018), LOS <14 days (HR 13.9; p = 0.007), and BI <30 (HR 2.76; p = 0.049) were the counterparts for females. Conclusions: Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m2, TCCI ≥5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality.
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Chang, Shih-Chieh, Chan-Lin Chu, Chih-Kuang Chen, Hsiang-Ning Chang, Alice M. K. Wong, Yueh-Peng Chen, and Yu-Cheng Pei. "The Comparison and Interpretation of Machine-Learning Models in Post-Stroke Functional Outcome Prediction." Diagnostics 11, no. 10 (September 28, 2021): 1784. http://dx.doi.org/10.3390/diagnostics11101784.
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Prediction of post-stroke functional outcomes is crucial for allocating medical resources. In this study, a total of 577 patients were enrolled in the Post-Acute Care-Cerebrovascular Disease (PAC-CVD) program, and 77 predictors were collected at admission. The outcome was whether a patient could achieve a Barthel Index (BI) score of >60 upon discharge. Eight machine-learning (ML) methods were applied, and their results were integrated by stacking method. The area under the curve (AUC) of the eight ML models ranged from 0.83 to 0.887, with random forest, stacking, logistic regression, and support vector machine demonstrating superior performance. The feature importance analysis indicated that the initial Berg Balance Test (BBS-I), initial BI (BI-I), and initial Concise Chinese Aphasia Test (CCAT-I) were the top three predictors of BI scores at discharge. The partial dependence plot (PDP) and individual conditional expectation (ICE) plot indicated that the predictors’ ability to predict outcomes was the most pronounced within a specific value range (e.g., BBS-I < 40 and BI-I < 60). BI at discharge could be predicted by information collected at admission with the aid of various ML models, and the PDP and ICE plots indicated that the predictors could predict outcomes at a certain value range.
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Chaiyawat, Pakaratee, Kongkiat Kulkantrakorn, and Paskorn Sritipsukho. "Effectiveness of home rehabilitation for ischemic stroke." Neurology International 1, no. 1 (August 25, 2009): 36. http://dx.doi.org/10.4081/ni.2009.e10.
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The objective of this study was to develop and examine the effectiveness of an individual home rehabilitation program for patients with ischemic stroke. This was a randomized controlled trial in 60 patients with recent middle cerebral artery infarction. After hospital discharge for acute stroke care, they were randomly assigned to receive either a home rehabilitation program for three months (intervention group) or usual care (control group). We collected outcome data over three months after their discharge from the hospital. The Barthel Index (BI), the Modified Rankin Scale (MRS), the health-related quality-of-life index (EQ-5D), the Hospital Anxiety and Depression score (HADs), and the Thai Mental State Examination (TMSE) were used to analyze the outcomes. In the intervention group, all outcomes were significantly better (p
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Bakheit, A. M. O., S. R. Harries, and R. G. Hull. "A Comparison between the Stanford Health Assessment Questionnaire and the Barthel Index in Patients with Rheumatoid Arthritis." British Journal of Occupational Therapy 58, no. 6 (June 1995): 253–55. http://dx.doi.org/10.1177/030802269505800608.
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Disability was measured in 33 patients with rheumatoid arthritis (RA) using the Stanford Health Assessment Questionnaire (HAQ) and a self-administered version of the Barthel index (BI). There was no significant disagreement between the two methods, although the HAQ showed a tendency to overestimate the degree of disability slightly. The findings suggest that the B1 is as reliable as the HAQ in the assessment of functional independence with activities of daily living in patients with RA. it also has the advantage of evaluating bladder and bowel control which is often affected in these patients. Most therapists are more familiar with the B1 than with the HAQ. The B1 could, therefore, be recommended for measuring rehabilitation gains in patients with RA.
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Feng, Yanqing, Ning Guo, Junxiu Liu, Xi Chen, Qiaosong Sun, Rong Lai, and Fan Huang. "Mycobacteria Infection in Incomplete Transverse Myelitis Is Refractory to Steroids: A Pilot Study." Clinical and Developmental Immunology 2011 (2011): 1–8. http://dx.doi.org/10.1155/2011/501369.
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Incomplete transverse myelitis (ITM) of unknown origin is associated with high rates of morbidity and mortality. This prospective, open-label study was undertaken to determine whether antituberculous treatment (ATT) might help patients with ITM whose condition continues to deteriorate despite receiving IV methylprednisolone treatment. The study consisted of 67 patients with steroid-refractory ITM in whomMycobacterium tuberculosis(MTB) was suspected clinically and in whom other known causes of myelopathy were excluded. The study occurred from January 2003 to June 2010. Patients underwent trial chemotherapy with ATT. Efficacy was assessed by the American Spinal Injury Association (ASIA) scoring system, the Barthel Index (BI) and the Hauser Ambulation Index (AI) at baseline, 12 months, and 24 months, using magnetic resonance imaging (MRI). Of the 67 patients enrolled, 51 were assessed and 16 withdrew. At 24 months, 49 patients experienced benefits as indicated by significantly increased ASIA and BI scores. The Hauser AI index also improved with markedly decreased abnormal signals in spinal cord MRI over time. The results from this prospective study provide beneficial clinical and MRI data on the efficacy of ATT in ITM patients and suggests mycobacteria may be an important and neglected cause of myelitis.
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Rajendran, Venkadesan, Deepa Jeevanantham, and Dylan Falk. "Effectiveness of Weekend Physiotherapy on Geriatric In-Patients’ Physical Function." Gerontology and Geriatric Medicine 8 (March 2022): 233372142211000. http://dx.doi.org/10.1177/23337214221100072.
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Purpose Hospital-associated disability (HAD) is significant among geriatric patients admitted to acute care hospitals. The objective of the study is to evaluate the effectiveness of additional weekend physiotherapy on mobility impairments of high-risk older patients admitted to the acute medical unit. Methods A prospective, non-randomized controlled trial was conducted in one of the medical units in a northern Ontario hospital. A total of 41 patients were recruited using a consecutive sampling method and assigned to a control group ( n = 19) and an experimental group ( n = 22). The de Morton Mobility Index (DEMMI) and the Barthel Index (BI) were the outcome measures. Results A Mann-Whitney U test was used to analyze the group differences, and it showed that there was a statistically significant difference ( p < .05) between the experimental and control groups on the DEMMI and the BI. Conclusion Additional weekend physiotherapy significantly improves elderly patients’ physical function and gets them physically ready for discharge when medically stable. This may significantly reduce the alternate level of care for patients.
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Kokura, Yoji, and Ryo Momosaki. "Prevalence of Malnutrition Assessed by the GLIM Criteria and Association with Activities of Daily Living in Older Residents in an Integrated Facility for Medical and Long-Term Care." Nutrients 14, no. 17 (September 4, 2022): 3656. http://dx.doi.org/10.3390/nu14173656.
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Malnutrition is associated with poor functional outcomes in residents in long-term care facilities. The integrated facility for medical and long-term care (IFMLC) is a new Japanese long-term care facility where medical services can be provided. This study aimed to investigate the prevalence of malnutrition diagnosed based on the Global Leadership Initiative on Malnutrition (GLIM) criteria and its association with activities of daily living (ADL) in older residents in IFMLC. In this cross-sectional study of older residents, we diagnosed mild and severe malnutrition using the GLIM criteria and assessed ADLs using the Barthel index (BI). Multivariate regression analysis was used to investigate the relationship between BI score and GLIM-defined malnutrition. A total of 117 older residents (84 women; median age, 88 years) were analyzed in this study. The prevalence values of mild and severe malnutrition were 29% and 18%, respectively. Multivariate analyses for the BI score after adjusting for potential confounders showed that mild and severe malnutrition were independently associated with BI score (B = −6.113, p < 0.046; B = −8.411, p = 0.015, respectively). GLIM-defined malnutrition is negatively associated with ADLs in older residents in IFMLC.
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Koumo, Masatoshi, Akio Goda, Yoshinori Maki, Kouta Yokoyama, Tetsuya Yamamoto, Tsumugi Hosokawa, Junichi Katsura, and Ken Yanagibashi. "Indicators Predicting Inpatient Mortality in Post-Stroke Patients Admitted to a Chronic Care Hospital: A Retrospective Pilot Study." Healthcare 10, no. 6 (June 2, 2022): 1038. http://dx.doi.org/10.3390/healthcare10061038.
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Evidence concerning the mortality of post-stroke patients admitted to a chronic-phase hospital seems to be lacking. This pilot study aimed to identify mortality-related clinical variables in the admission of post-stroke patients from a retrospective perspective. A group of 38 non-survival stroke patients and another group of 46 survival stroke patients in a chronic-phase ward of the single center were recruited. Clinical variables including age, sex, stroke type, and Barthel index (BI) score were collected. The difference in the age and BI scores on admission were statistically significant between the two groups (p < 0.01). Polytomous logistic regression analysis revealed that age (odds ratio = 1.09, p = 0.03, and 95% confidence interval: 1.01–1.07), male sex (odds ratio = 5.04, p = 0.01, and 95% confidence interval: 1.39–18.27), and BI scores on admission (odds ratio = 0.90, p = 0.01, and 95% confidence interval: 0.83–0.97) could be prognostic variables. The percentage of correct classification was 83.3%. Age, male sex, and BI scores on admission may be prognostic indicators. The result of this study could lay the groundwork for palliative care for such a clinical population.
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Sarfaraz, Aisha, Dr Abdul Azeem, Mehwish Butt, and Muhammad Umar. "FREQUENCY OF FUNCTIONAL DISABILITY AND COGNITIVE IMPAIRMENTS IN SUB-ACUTE STROKE PATIENTS." Pakistan Journal of Rehabilitation 10, no. 2 (July 6, 2021): 69–74. http://dx.doi.org/10.36283/pjr.zu.10.2/013.
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BACKGROUND & OBJECTIVE Stroke is a very common neurological condition affects various aspects of health. The primary objective of this study was to find out the frequency of functional disability and cognitive impairments in Sub-acute Stroke patients. MATERIAL AND METHODS A cross-sectional survey was conducted on 112 Sub-acute Stroke patients in Karachi, Pakistan. Using Barthel Index (BI) and Mini-Mental State Examination (MMSE) test was used to find out the frequency of functional disability and cognitive impairments of Sub-acute Stroke patients. RESULTS The correlation of BI scores with MMSE scores for the Male gender was 0.576 whilst the correlation of BI scores with MMSE scores for the Female gender was 0.440. The severity of functional disability concerning age groups assessed P-value was 0.026 using Chi-Square Test. The severity of functional disability (BI severity) concerning gender, P-value was found 0.097 using the same test. CONCLUSION Functional Disability is directly linked with age. However, there was no linkage established between Cognitive Impairment and age as well as gender. On close inspection, there was a trend between Functional disability and gender but not statistically significant.
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Kurt, Erhan, Ilhan Karacan, Nihal Ozaras, and Gazi Alatas. "Affective temperament in stroke patients." Acta Neuropsychiatrica 20, no. 6 (December 2008): 295–99. http://dx.doi.org/10.1111/j.1601-5215.2008.00335.x.
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Objective:The aims of this study were to determine the dominant affective temperament changes in stroke survivors and whether temperament affects the disability.Methods:A total of 63 stroke patients were included in this study. Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire was used to determine the dominant affective temperament (depressive, hyperthymic, cyclothymic, irritable or anxious). The disability level was measured with the Barthel index (BI).Results:Depressive temperament (17.5%) and anxious temperament (12.7%) were the most common dominant affective temperaments. The frequencies of irritable, cyclothymic and hyperthymic temperaments were 4.8, 3.2 and 0%, respectively. The mean BI score was 78.1 ± 18.3 in patients with depressive temperament and 67.4 ± 28.4 in patients without depressive temperament (p = 0.403). The mean BI score was 78.1 ± 15.3 in patients with anxious temperament and 68.0 ± 28.3 in patients without anxious temperament (p = 0.541). Multiple linear regression analysis indicated that BI score was not associated with affective temperament changes.Conclusion:The results of the current study suggest that depressive and anxious temperaments are the most common affective temperaments and that there appears to be no association between disability level and dominant affective temperament in stroke survivors.
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Lopez-Espuela, Fidel, Juan Diego Pedrera Zamorano, José María Ramírez-Moreno, Pedro Enrique Jiménez-Caballero, Juan Carlos Portilla-Cuenca, Jesús María Lavado-García, and Ignacio Casado-Naranjo. "Determinants of Quality of Life in Stroke Survivors After 6 Months, from a Comprehensive Stroke Unit." Biological Research For Nursing 17, no. 5 (October 6, 2014): 461–68. http://dx.doi.org/10.1177/1099800414553658.
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Background: In the social model of stroke, health-related quality of life (HRQoL) is the result of interplay among stroke severity, social support, and health-promoting behaviors. Our objective was to identify determinants of HRQoL in stroke survivors. Methods: Ischemic stroke patients were evaluated at 6 months with the Short Form 12 Health Survey, including physical component survey (PCS) and mental health component survey (MCS) summary scores. Multivariate stepwise regression analyses determined independent predictors of scores. Models included age, gender, socioeconomic class, education, residential environment, social support, previous comorbidity (Charlson Index), previous stroke, side of stroke, National Institutes of Health Stroke Scale (NIHSS) score at admission, Barthel Index (BI) and modified Rankin Scale (mRS) scores at discharge, and length of stay. Results: A total of 131 patients participated (mean age 70.1, SD = 12.5; 62.6% males). In all, 33.6% had a BI score <90 and an mRS score >2 (poor outcome). The mean ( SD) PCS score was 39.46 (9.3) and mean ( SD) MCS score was 34.86 (10.1). Lower PCS score was associated with female sex (β = 0.204, p = .009), poor social support (β = −0.225, p = .003), and poor Charlson Index (β = −0.162, p = .032) and BI scores (β = 0.384, p < .0001). Lower MCS score was associated with female sex (β = 0.162, p = .062) and poor NIHSS (β = −0.265, p = .019) and BI scores (β = 0.203, p < .071). Conclusion: Stroke severity, disability, gender, social support, and previous stroke have significant impacts on the physical and mental domains of generic HRQoL.
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Markišić, Merdin, Aleksandra M. Pavlović, and Dragan M. Pavlović. "The Impact of Homocysteine, Vitamin B12, and Vitamin D Levels on Functional Outcome after First-Ever Ischaemic Stroke." BioMed Research International 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/5489057.
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We explored the relationship between acute ischaemic stroke (IS) early functional outcome and serum levels of homocysteine, vitamin B12, and D in a noninterventional prospective clinical study. We enrolled 50 patients with first-ever IS and performed laboratory tests and functional assessment at three time points: on admission and three and six months after stroke. Modified Rankin Scale (mRS), NIHSS scale, and Barthel index (BI) scores were assessed in all participants by trained examiner blinded to laboratory data. Patients did not receive treatment that might alter laboratory data. Admission NIHSS correlated with homocysteine levels (r=0.304,p<0.05), B12 level (r=-0.410,p<0.01), and vitamin D levels (r=-0.465,p<0.01). Functional outcome measures (BI and mRS) did not significantly correlate with homocysteine and vitamin D3 levels at 3 and 6 months. However, a positive correlation with vitamin B12 levels was detected for BI both at 3 and 6 months and mRS at 6 months. Higher serum vitamin B12 levels were associated with better functional outcome at follow-up.
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Grasso, M. G., E. Troisi, F. Rizzi, D. Morelli, and S. Paolucci. "Prognostic factors in multidisciplinary rehabilitation treatment in multiple sclerosis: an outcome study." Multiple Sclerosis Journal 11, no. 6 (December 2005): 719–24. http://dx.doi.org/10.1191/1352458505ms1226oa.
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The aim of this outcome study was to evaluate the effectiveness and prognostic factors of inpatient multidisciplinary rehabilitation treatment in patients with multiple sclerosis (MS). We analysed 230 consecutive inpatients with MS admitted to an MS rehabilitation ward who followed an individualized, goal-oriented, multidisciplinary rehabilitation program. Every patient was submitted to a neurological examination and evaluated by means of Kurtzke’s Expanded Disability Status Scale (EDSS), with its functional systems (FS), Barthel Index (BI) and the Rivermead Mobility Index (RMI). We observed an effectiveness (percentage of potential improvement achieved during rehabilitation) of nearly 16% on BI and 8% on RMI, corresponding to an improvement in 124 patients (54%) on BI and 113 patients (49%) on RMI. Basal EDSS (β= -0.32, p<0.001), cognitive status (β= -0.15, p<0.05) and disease duration (β= -0.13, p<0.05) were negatively associated with effectiveness of treatment on BI (adjusted R2=0.176), whereas effectiveness on RMI was correlated only with the EDSS score (β=-0.34, p<0.001, adjusted R2=0.113). In the logistic regression analysis, the absence of severe sphincteric disturbances was correlated with the probability of improvement on BI that was nearly twice as high (OR=2.25, 95% CI 1.24-4.08) as that of other patients. Moreover, patients without severe cognitive deficits showed a similar probability (OR-2.37, 95% CI 1.05-5.33) of improvement on RMI. The results of this study provide further evidence that intensive multidisciplinary rehabilitation in MS is effective in the majority of MS patients and that early treatment may favour functional recovery.
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Cabañero-Martínez, M. José, Julio Cabrero-García, Miguel Richart-Martínez, and Carmen Luz Muñoz-Mendoza. "The Spanish versions of the Barthel index (BI) and the Katz index (KI) of activities of daily living (ADL): A structured review." Archives of Gerontology and Geriatrics 49, no. 1 (July 2009): e77-e84. http://dx.doi.org/10.1016/j.archger.2008.09.006.
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de Ridder, Inger R., Simone A. Dijkland, Maaike Scheele, Heleen M. den Hertog, Maaike Dirks, Willeke F. Westendorp, Paul J. Nederkoorn, et al. "Development and validation of the Dutch Stroke Score for predicting disability and functional outcome after ischemic stroke: A tool to support efficient discharge planning." European Stroke Journal 3, no. 2 (January 25, 2018): 165–73. http://dx.doi.org/10.1177/2396987318754591.
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Introduction We aimed to develop and validate a prognostic score for disability at discharge and functional outcome at three months in patients with acute ischemic stroke based on clinical information available on admission. Patients and methods The Dutch Stroke Score (DSS) was developed in 1227 patients with ischemic stroke included in the Paracetamol (Acetaminophen) In Stroke study. Predictors for Barthel Index (BI) at discharge (‘DSS-discharge’) and modified Rankin Scale (mRS) at three months (‘DSS-3 months’) were identified in multivariable ordinal regression. The models were internally validated with bootstrapping techniques. The DSS-3 months was externally validated in the PRomoting ACute Thrombolysis in Ischemic StrokE study (1589 patients) and the Preventive Antibiotics in Stroke Study (2107 patients). Model performance was assessed in terms of discrimination, expressed by the area under the receiver operating characteristic curve (AUC), and calibration. Results At model development, the strongest predictors of Barthel Index at discharge were age per decade over 60 (odds ratio = 1.55, 95% confidence interval (CI) 1.41–1.68), National Institutes of Health Stroke Scale (odds ratio = 1.24 per point, 95% CI 1.22–1.26) and diabetes (odds ratio = 1.62, 95% CI 1.32–1.91). The internally validated AUC was 0.76 (95% CI 0.75–0.79). The DSS-3 months, additionally consisting of previous stroke and atrial fibrillation, performed similarly at internal (AUC 0.75, 95% CI 0.74–0.77) and external validation (AUC 0.74 in PRomoting ACute Thrombolysis in Ischemic StrokE (95% CI 0.72–0.76) and 0.69 in Preventive Antibiotics in Stroke Study (95% CI 0.69–0.72)). Observed outcome was slightly better than predicted. Discussion: The DSS had satisfactory performance in predicting BI at discharge and mRS at three months in ischemic stroke patients. Conclusion If further validated, the DSS may contribute to efficient stroke unit discharge planning alongside patients' contextual factors and therapeutic needs.
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Kormas, Constantinos, Eleni Vidali, and Evangelos Lymperopoulos. "MOTOR PROGRAMMING PREDICTS THE FUNCTIONAL RECOVERY GAIN IN PATIENTS WITH RIGHT HEMISPHERIC FRONTAL STROKE." Acta Neuropsychologica 18, no. 3 (July 1, 2020): 339–45. http://dx.doi.org/10.5604/01.3001.0014.3311.
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Executive functioning significantly affects the functional rehabilitation progress in stroke patients. The current study are aimed to examine the impact of executive functions on functional recovery gain in a sample of right hemispheric (RH) frontal stroke patients. A total of 50 inpatients admitted to the Theseus Rehabilitation Center and diagnosed with RH frontal stroke were included in this study. The initial assessment of executive functioning was conducted using the Frontal Assessment Battery (FAB). Functional recovery of basic activities of daily living (ADLs) was computed by the difference between follow-up and baseline Barthel Index (BI) scores. Pearson’s analysis revealed that the FAB global scores significantly correlated with the BI gain scores. Additionally, multiple regression analysis showed a significant contribution of only motor programming to the basic ADLs recovery gain. The global status of executive function was found to be significantly associated with functional recovery gain, and motor programming was the strongest predictor in RH frontal stroke patients. These findings are discussed for the treatment rehabilitation prognosis.
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Sánchez Silverio, Víctor, Vanesa Abuín Porras, and Isabel Rodríguez Costa. "Dynamic Balance Performance In Relation To the Dependence in Activities of Daily Living: A Cross-Sectional Study in Stroke Patients." Journal of Clinical Research and Reports 4, no. 5 (July 15, 2020): 01–04. http://dx.doi.org/10.31579/2690-1919/103.
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Aim: to determine if dynamic balance is related to activities of daily living (ADL) dependence in stroke patients. Methods: a cross-sectional study was carried out. The Barthel index (BI) was used to assess ADL dependence. The Timed Up and Go Test (TUG) and the Four Square Step Test (FSST) were used to evaluate dynamic balance. A Spearman correlation was used assuming a data abnormality in the performance of TUG and FSST and considering a significance of p<0.05. Results: 62 stroke patients were evaluated. The BI showed correlations with the performance of the TUG and the FSST. These correlations were also found between performance of both balance tests and ADLs, such as bathing, moving, and going up and down stairs. In contrast to TUG, correlations were estimated between the ADL related to dressing and the performance of the FSST. Conclusion: dynamic balance evaluated by the TUG and the FSST showed correlations with the ADL dependency in stroke patients.
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Barak, Yoram, Yair Lampl, Ehud Bodner, and Ida Sarova Pinchas. "Perception of Body Esteem Following Stroke." Neurorehabilitation and Neural Repair 13, no. 1 (March 1999): 1–4. http://dx.doi.org/10.1177/154596839901300102.
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Psychopathologic disturbances have been reported as a sequela of ischemic stroke. We have exammed various body esteem dimensions in 101 patients following a stroke. The patients were examined 6 months after the stroke. They were scored with the Barthel Index (BI) as the disability score, the Hamilton Depression Scale (HDS), and the Body Esteem Scale (BES). A significant lower body esteem (p < 0.0001) was found for both sexes and for all body esteem subscales in subjects suffering from a left corti cal lesion compared with other stroke locations. Physical attractiveness subscores among males were significantly lower in subjects with a right cortical lesion (p < 0.005). No correlation was found between time of disability and body esteem except on the upper body strength (V) subscale among males (p = 0.04). No correlation was found between the BI, size of lesion, or age and BES. These findings demonstrate that im pairment of body esteem following stroke is correlated with lesion location, not its size or associated disability score.
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Estrada-Barranco, Cecilia, Roberto Cano-de-la-Cuerda, Vanesa Abuín-Porras, and Francisco Molina-Rueda. "Postural Assessment Scale for Stroke Patients in Acute, Subacute and Chronic Stage: A Construct Validity Study." Diagnostics 11, no. 2 (February 21, 2021): 365. http://dx.doi.org/10.3390/diagnostics11020365.
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(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months).
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López-Liria, Remedios, Francisco Antonio Vega-Ramírez, José Manuel Aguilar-Parra, David Padilla-Góngora, Rubén Trigueros-Ramos, and Patricia Rocamora-Pérez. "Evaluation of the Effectiveness of a Nursing/Physiotherapy Program in Chronic Patients." International Journal of Environmental Research and Public Health 16, no. 12 (June 25, 2019): 2236. http://dx.doi.org/10.3390/ijerph16122236.
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This study aimed to evaluate the functional impact of a shared intervention model by the mobile physiotherapy and rehabilitation team (MPRT) and primary care case management nurses (PCCMNs) on chronic patients. This was a prospective, observational study involving 1086 patients (mean age, 80 years; 63.7% females) in the province of Almeria, which was conducted between 2004 and 2018. Most of the registered diseases included cerebrovascular and neurological diseases (56.7%), osteoarticular diseases (45.3%), diabetes mellitus (25.7%), cardiovascular diseases (25.5%), and chronic respiratory diseases. The study included a home care intervention by the MPRT and PCCMNs and included the following main outcome measures: age, sex, main caregiver, disabling process (ICD-9), type and number of inclusion categories for chronic disease, initial and final Barthel index (BI), treatment or intervention on the patient (techniques), objectives, and number of sessions. The main techniques used were kinesiotherapy (44.6%) and caregiver training (23%), along with technical aid. An equation predicting the patients’ final BI, according to the initial BI, was constructed using multiple linear regression modelling. A marked improvement in functional capacity was found after an average of 10 physiotherapy sessions. A lower patient age was correlated with a higher functional capacity, both initial and final BI, as well as a greater number of sessions.
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Prata, Melina Galetti, and Marcos Eduardo Scheicher. "Correlation between balance and the level of functional independence among elderly people." Sao Paulo Medical Journal 130, no. 2 (2012): 97–101. http://dx.doi.org/10.1590/s1516-31802012000200005.
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CONTEXT AND OBJECTIVE: As the overall number of elderly people increases there is a corresponding rise in the number of older persons with disabilities. In order to examine whether there is any relationship between balance and activities of daily living, we evaluated balance and daily activities among elderly people living in the community. DESIGN AND SETTING: Cross-sectional study at Universidade Estadual Paulista (Unesp), Marília, São Paulo, Brazil. METHODS: The study included 70 community-dwelling elderly people aged 65 and over. Balance was evaluated using the Berg Balance Scale (BBS) and physical independence in daily activities was evaluated using the Barthel Index (BI). The Spearman correlation coefficient was used to examine the relationship between the parameters evaluated. Significance was set at the level of 5% (P < 0.05). RESULTS: The population's mean age was 70.5 ± 5 years. The mean BBS score was 50.9 ± 4.1, whereas the mean BI score was 98.1 ± 2.8. Statistically significant relationships were found between the BBS and BI (r = 0.41; P = 0.0004); between age and BI (r = -0.24; P = 0.04); and between age and BBS (r = -0.57; P = 0.0001). CONCLUSIONS: The results showed that among elderly people, there are correlations between age, balance and independence level.
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Ciancarelli, Irene, Giovanni Morone, Marco Iosa, Stefano Paolucci, Loris Pignolo, Paolo Tonin, Antonio Cerasa, and Maria Giuliana Tozzi Ciancarelli. "Adipokines as Potential Biomarkers in the Neurorehabilitation of Obese Stroke Patients." Current Neurovascular Research 17, no. 4 (December 14, 2020): 437–45. http://dx.doi.org/10.2174/1567202617666200603150901.
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Background: Limited studies concern the influence of obesity-induced dysregulation of adipokines in functional recovery after stroke neurorehabilitation. Objective: To investigate the relationship between serum leptin, resistin, and adiponectin and functional recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential significance as prognostic markers of rehabilitation outcomes was also verified. Methods: Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale (mRS), and Functional Independence Measure (FIM). Results: Compared to controls, higher leptin and resistin values and lower adiponectin values were observed in stroke patients before neurorehabilitation and no correlations were found between adipokines and clinical outcome measures. Neurorehabilitation was associated with improved scores of BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and resistin together increased adiponectin were detected in stroke patients, while leptin decreased but not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score, and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified leptin as prognostic factor for BI, mRS, and FIM. Conclusions: Our data show the effectiveness of neurorehabilitation in modulating adipokines levels and suggest that leptin could assume the significance of biomarker of functional recovery.