Journal articles on the topic 'Recovery outcome'
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Noel, V. A., P. E. Deegan, and R. E. Drake. "Measuring recovery as an outcome." Die Psychiatrie 12, no. 03 (July 2015): 174–79. http://dx.doi.org/10.1055/s-0038-1669600.
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Summary Background: As the concept of recovery has become increasingly popular in mental health treatment settings, professionals have attempted to measure recovery as an outcome. Aims: This article reviews the history of the concept of recovery and recent attempts to measure recovery as an outcome. Results: The concept of recovery, as developed by people who experienced mental health problems, emphasizes the process of learning to live a meaningful life in spite of vulnerabilities and symptoms. Traditional outcome studies assess recovery as cure or return to premorbid functioning, not in this new sense of developing quality of life. Newer measures attempt to assess the process and outcomes of recovery, but with minimal consistency, reflecting the heterogeneity of definitions, populations, and programs. Attempts to measure recovery may, nevertheless, move the mental health system, programs, and professionals closer to understanding and honoring the ideals of recovery that are so meaningful to service users.
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Cai, Lingfei, Xuan Shi, and Jingrong Zhu. "Quality Recovery or Low-End Recovery? Profitability and Environmental Impact of Durable Product Recovery." Sustainability 11, no. 6 (March 21, 2019): 1726. http://dx.doi.org/10.3390/su11061726.
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With the rising awareness of environmental responsibility in industrial production, a series of recovery strategies have been developed and play different roles in achieving sustainability. In this study, we examine when quality recovery, low-end recovery, and hybrid recovery result in a win-win outcome where both profitability and environmental performance can be improved for a durable product manufacturer. We develop a game-theoretic model to analyze the manufacturer’s payoffs under different recovery strategies. A secondary market where used products can be resold among consumers is also considered. We obtain the results by comparing the profitability and environmental impact under each recovery strategy. Hybrid recovery causes both synergy and a contradiction effect between quality and low-end recovery. It always improves the win-win outcome of low-end recovery and it can also improve the win-win outcome of quality recovery under a high recovery standard when the recovered value is not too high. The technology improvement only achieves environmental sustainability under sufficient stringent recovery standard, otherwise, it may backfire and deteriorate the environment. We offer insights for the policymaker to understand the role of the recovery standard in achieving the win-win outcome and the importance of setting a proper recovery standard in achieving environmental sustainability.
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Colón-Emeric, Cathleen, Carl F. Pieper, Kenneth E. Schmader, Richard Sloane, Allison Bloom, Micah McClain, Jay Magaziner, et al. "Two Approaches to Classifying and Quantifying Physical Resilience in Longitudinal Data." Journals of Gerontology: Series A 75, no. 4 (April 17, 2019): 731–38. http://dx.doi.org/10.1093/gerona/glz097.
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Abstract Background Approaches for quantifying physical resilience in older adults have not been described. Methods We apply two conceptual approaches to defining physical resilience to existing longitudinal data sets in which outcomes are measured after an acute physical stressor. A “recovery phenotype” approach uses statistical methods to describe how quickly and completely a patient recovers. Statistical methods using a recovery phenotype approach can consider multiple outcomes simultaneously in a composite score (eg, factor analysis and principal components analysis) or identify groups of patients with similar recovery trajectories across multiple outcomes (eg, latent class profile analysis). An “expected recovery differential” approach quantifies how patients’ actual outcomes are compared to their predicted outcome based on a population-derived model and their individual clinical characteristics at the time of the stressor. Results Application of the approaches identified different participants as being the most or least physically resilient. In the viral respiratory cohort (n = 186) weighted kappa for agreement across resilience quartiles was 0.37 (0.27–0.47). The expected recovery differential approach identified a group with more comorbidities and lower baseline function as highly resilient. In the hip fracture cohort (n = 541), comparison of the expected recovery differentials across 10 outcome measures within individuals provided preliminary support for the hypothesis that there is a latent resilience trait at the whole-person level. Conclusions We posit that recovery phenotypes may be useful in clinical applications such as prediction models because they summarize the observed outcomes across multiple measures. Expected recovery differentials offer insight into mechanisms behind physical resilience not captured by age and other comorbidities.
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Janca, Aleksandar, and Sivasankaran Balaratnasingam. "Schizophrenia across the world: outcome and recovery." International Psychiatry 9, no. 1 (February 2012): 9–11. http://dx.doi.org/10.1192/s1749367600002903.
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The International Pilot Study of Schizophrenia (IPSS) was a seminal, ground-breaking study that revealed important information regarding schizophrenia on a global scale. Perhaps the most interesting and controversial finding was that for all outcome variables considered, patients suffering from schizophrenia in Nigeria and India (‘developing countries’) tended to ‘recover’ better than patients in the other six sites. However, in recent times, this finding has been repeatedly challenged. The renewed debate led to a vigorous rebuttal by some of the original IPSS study authors. In an increasingly globalised world, the IPSS stands as a reminder of the importance of the cultural determinants of recovery from schizophrenia.
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Pinsker, Ellie, Monique A. M. Gignac, Joanna E. M. Sale, Timothy R. Daniels, and Dorcas E. Beaton. "Understanding “Recovery” Following Ankle Reconstruction: A Qualitative Study." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0034. http://dx.doi.org/10.1177/2473011419s00340.
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Category: Ankle, Ankle Arthritis, Outcomes research Introduction/Purpose: Patients’ perception of a good outcome (‘feeling recovered’) is not fully understood. A clear understanding of the benefits and harm of a surgery is necessary for clinical decision-making. Qualitative work exploring the nature of patient recovery would improve our ability to understand and measure these outcomes. The purpose of the study is to examine patients’ perceptions of post-surgical outcome following ankle reconstruction for treatment of end-stage ankle arthritis. Methods: Twenty-five English-speaking individuals were asked to participate following a routine clinic visit. They were recruited from an existing cohort of persons who had undergone total ankle replacement or ankle fusion at least one year prior. A qualitative researcher conducted semi-structured, face-to-face interviews with participants in a private hospital room. Results: Twenty-five adults (12 women, 13 men) ages 25–82 years were interviewed for 1-2 hours. Participants varied in their socioeconomic status and education levels. Patients did not view their recovery simply as physiological change. Most participants reported ongoing challenges or difficulties, yet considered themselves better. Participants described a broader concept of recovery with multiple contributing factors, including appraisal of the importance of ongoing issues and coping efforts. When participants experienced ongoing difficulty with valued activities, they gained a sense of recovery using coping efforts. Many ‘readjusted’ behaviorally to continue with their valued goals and activity preferences. Others cognitively redefined their goals or preferences to accommodate their ongoing issues. Participants who could not cope with their difficulties or disliked their coping effort perceived their recovery negatively. Conclusion: Perception of recovery and experience of outcome rarely involved resolution of all symptoms and functional limitations. The manner in which patients described their recovery was typically more nuanced than a simple change in magnitude of symptoms or functional limitations. This research expands our understanding of the experience of ankle reconstruction and draws attention to different meanings of recovery that has implications for outcome evaluation and measurement. Improved measures for evaluating the recovery outcome states will enable clinicians to identify facilitators and barriers to recovery.
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Pinsker, Ellie, Taucha Inrig, Timothy R. Daniels, Kelly Warmington, and Dorcas E. Beaton. "Symptom Resolution and Patient-Perceived Recovery Following Ankle Arthroplasty and Arthrodesis." Foot & Ankle International 37, no. 12 (August 20, 2016): 1269–76. http://dx.doi.org/10.1177/1071100716660820.
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Background: Patients’ perception of outcomes is not always defined by the absence of limitations/symptoms (resolution), but can also be characterized by behavioral adaptation and cognitive coping arising in cases with residual deficits. Patient-reported outcome measures (PROs) are designed to measure levels of function or symptoms, largely missing whether patients are coping with ongoing limitations. This study aimed to broaden the conventional definition of a “satisfactory” outcome following ankle reconstruction by comparing patient-reported outcomes of patients with and without residual symptoms and limitations. Methods: The study consisted of a cross-sectional survey of ankle arthroplasty (n = 85) and arthrodesis (n = 15) patients. Outcome measures included the Ankle Osteoarthritis Scale, Short Musculoskeletal Function Assessment, Short Form-12, and EuroQol-5 Dimension. Patients also completed measures of pain (0-10), stiffness (0-10), satisfaction (0-3), and ability to complete activities of daily living (ADL) (0-6). Based on a self-reported question regarding recovery and coping, patients were categorized as “Recovered-Resolved” (better with no symptoms or residual effects), “Recovered, not Resolved” (RNR, better with residual effects), or “Not Recovered” (not better). Recovery groups were compared across measures. Results: Only 15% of patients were categorized Recovered-Resolved. Most were RNR (69%), leaving 14% Not Resolved. Recovered-Resolved experienced lower rates of pain (1.4 ± 2.3), stiffness (1.1 ± 2.6), and difficulty performing ADLs (0.9 ± 1.2). Overall, outcome measure scores were high (ie, better health) for Recovered-Resolved patients, midrange for RNR patients, and low for Not Recovered patients, thus confirming predefined hypotheses. Recovered-Resolved and RNR patients had similarly high satisfaction summary scores (3.0 ± 0.0 vs 2.6 ± 0.6). Conclusion: Most patients reported positive outcomes, but few (15%) experienced resolution of all symptoms and limitations. Current PROs focus on achieving low levels of symptoms and limitations, but miss an important achievement when patients are brought to a level of residual deficits with which they can cope. Patients’ perceptions of satisfactory outcomes were not predicated on the resolution of all limitations; thus, the conventional definition of “satisfactory” outcomes should be expanded accordingly. Level of Evidence: Level II, prospective cohort study.
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Piccinelli, Marco, and Greg Wilkinson. "Outcome of Depression in Psychiatric Settings." British Journal of Psychiatry 164, no. 3 (March 1994): 297–304. http://dx.doi.org/10.1192/bjp.164.3.297.
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We reviewed follow-up studies of adults with depressive disorders seen in psychiatric settings, and noted outcomes in terms of recovery, recurrence, and persistent depression, at six months, one year, two to five years, and ten or more years after an index episode of depression. Recovery increased with time: about half recovered at least briefly by six months, and a large majority did so in the long term. Only about a quarter recovered from an index episode and remained well more than ten years thereafter. A quarter of patients suffered recurrence of depression within a year of an index episode, and three-quarters did so at least once during follow-up periods lasting more than ten years. For more than one in ten patients, the depression proved persistent, the proportion affected remaining relatively stable over time. The review highlighted a relative paucity of conclusive investigations on the outcome of the commonest psychiatric disorder in clinical settings.
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ZOLER, MITCHEL L. "Rapid Lymphopenia Recovery Predicts Better Outcome." Hospitalist News 3, no. 7 (July 2010): 20. http://dx.doi.org/10.1016/s1875-9122(10)70185-1.
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Shrivastava, A. "Do we Need to Review Outcome Measures in Schizophrenia to Capture ‘Real-life’ Situation?" European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70581-4.
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Introduction:Outcome measures in schizophrenia are defining aspects for deciding the status of recovery based upon which people’ scientific body forms opinions. It is also important in dealing with stigma related to schizophrenia. Recently the concept of ‘recovery’ and’ outcome’ has come under scientific scrutiny. Literature does not show a consistent pattern in outcome. Both short term and long-term outcome show variability, which is often, explained by cultural factors. It has been generally considered that devolved countries have poor outcome than developing, non-industrialized countries. This view has also been challenged recently. The paper draws from the conceptual aspects if our outcome measure are capturing ‘real-life’ situation. We conducted two studies in Mumbai, India:1.Study of stigma & discrimination, which brought out the facts of families’ expectation and disappointments with level of recovery.2.A 10 years long term study, to determine recovery status of recovered patients.80% patients and families felt that recovery is inadequate and short of social integration despite continued treatment in stigma study. In outcome study, 60% patients showed good recovery as per CGIS. These patients were reassessed on 13 outcome criteria's of Meltzer. It is observed tat half of the patients who recovered continue to live with symptoms, a quarter with varying suicidality and side effects, most of the patients were not socially integrated, majority have not returned to productivity, employment and education It is concluded that outcome criteria's need a thoughtful revision and a new perspective to capture ground reality.
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Shrivastava, A. "Do We Need to Review Outcome Measures in Schizophrenia to Capture ‘Real-life’ Situation?" European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71429-4.
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Introduction:Outcome measures in schizophrenia are defining aspects for deciding the status of recovery based upon which people’ scientific body forms opinions. It is also important in dealing with stigma related to schizophrenia. Recently the concept of ‘recovery’ and ’ outcome’ has come under scientific scrutiny. Literature does not show a consistent pattern in outcome. both short term and long-term outcome show variability, which is often, explained by cultural factors. It has been generally considered that devolved countries have poor outcome than developing, non-industrialized countries. This view has also been challenged recently. the paper draws from the conceptual aspects if our outcome measure are capturing ‘real-life’ situation. We conducted two studies in Mumbai, India:1.Study of stigma & discrimination, which brought out the facts of families’ expectation and disappointments with level of recovery.2.A 10 years long term study, to determine recovery status of recovered patients.80% patients and families felt that recovery is inadequate and short of social integration despite continued treatment in stigma study. in outcome study, 60% patients showed good recovery as per CGIS. These patients were reassessed on 13 outcome criteria's of Meltzer. It is observed tat half of the patients who recovered continue to live with symptoms, a quarter with varying suicidality and side effects, most of the patients were not socially integrated, majority have not returned to productivity, employment and education It is concluded that outcome criteria's need a thoughtful revision and a new perspective to capture ground reality.
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McGrath, J. J., J. Miettunen, E. Jääskeläinen, and F. Dark. "The onset and offset of psychosis – and what happens in between." Psychological Medicine 44, no. 13 (June 6, 2014): 2705–11. http://dx.doi.org/10.1017/s0033291714001378.
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As one would expect for a heterogeneous syndrome like schizophrenia, at the individual level the course of symptoms and disability vary widely. Mindful that the definition of recovery/remission varies widely between studies, a recent systematic review and meta-analysis reported that the proportion of those with schizophrenia who recover on both symptom and functional outcome is modest (approximately 14%). A 10-year follow-up of the English multicentre AESOP incidence study provides more ‘fine-grained’ insights into the time course of symptom fluctuation for schizophrenia and other psychotic disorders. We highlight selected findings from the new study and speculate on the role of different outcome domains for future study (e.g. symptom, occupational/functional, cognition, physical health, patient-nominated outcomes). Because recovery is a multifaceted process, we need to develop a panel of practical and operationalizable criteria for remission and recovery.
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Power, Paddy. "Outcome and recovery in first-episode psychosis." British Journal of Psychiatry 211, no. 6 (December 2017): 331–33. http://dx.doi.org/10.1192/bjp.bp.117.205492.
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SummaryThere is now a good body of evidence about factors that determine outcome and recovery in a first episode of psychosis. However, so far, this is of limited benefit when making predictions at an individual level. Treatment protocols are one size fits all and the recommended duration of medication remains unclear. What is needed is a more sophisticated approach to predicting outcomes and tailoring treatment options to the individual. Removing predisposing factors is an important aspect of this.
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Mourits, B. M. P., M. Z. Meulekamp, P. van der Wurff, and C. Lucas. "Identifying prognostic factors to determine the level of recovery in servicemembers with chronic low back pain: A prospective cohort study." Journal of Back and Musculoskeletal Rehabilitation 34, no. 4 (July 13, 2021): 697–705. http://dx.doi.org/10.3233/bmr-200123.
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OBJECTIVE: The main objective of this study was to identify general and military-related factors that are associated with the level of recovery in Dutch service members with chronic low back pain (CLBP) who followed a rehabilitation program. MATERIAL AND METHOD: One hundred five consecutive service members with CLBP were included in this study. The level of disability, was used to distinguish a recovered and non-recovered group. Level of pain and self-perceived recovery were used as secondary outcome measurements. Differences were evaluated within and between the groups using the Student’s t-test Bivariate logistic regression analyses were used for identifying the prognostic factors related to various outcomes of recovery RESULTS: After following the rehabilitation program, 64.8% of the service members recovered from CLBP. The recovered group, demonstrated significant effect sizes in disability and in pain The non-recovered group showed on disability a non-significant effect and in pain a significant effect. The self-perceived recovery in the recovered group was “much improved” and the non-recovered group “slightly improved”. The results of the bivariate regression analyses showed no significant independent prognostic factors related to recovery. CONCLUSIONS: In this study, no significant independent prognostic factors could be identified that were associated to the various outcomes of recovery in service members with CLBP who followed a rehabilitation program.
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Truss, Katie, Stephen J. C. Hearps, Franz E. Babl, Michael Takagi, Gavin A. Davis, Cathriona Clarke, Nicholas Anderson, et al. "Trajectories and Risk Factors for Pediatric Postconcussive Symptom Recovery." Neurosurgery 88, no. 1 (July 27, 2020): 36–45. http://dx.doi.org/10.1093/neuros/nyaa310.
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Abstract BACKGROUND Persistent postconcussive symptoms (PCS) are poorly understood in children. Research has been limited by an assumption that children with concussion are a homogenous group. OBJECTIVE To identify (i) distinctive postconcussive recovery trajectories in children and (ii) injury-related and psychosocial factors associated with these trajectories. METHODS This study is part of a larger prospective, longitudinal study. Parents of 169 children (5-18 yr) reported their child's PCS over 3 mo following concussion. PCS above baseline levels formed the primary outcome. Injury-related, demographic, and preinjury information, and child and parent mental health were assessed for association with trajectory groups. Data were analyzed using group-based trajectory modeling, multinomial logistic regression, and chi-squared tests. RESULTS We identified 5 postconcussive recovery trajectories from acute to 3 mo postinjury. (1) Low Acute Recovered (26.6%): consistently low PCS; (2) Slow to Recover (13.6%): elevated symptoms gradually reducing; (3) High Acute Recovered (29.6%): initially elevated symptoms reducing quickly to baseline; (4) Moderate Persistent (18.3%): consistent, moderate levels of PCS; (5) Severe Persistent (11.8%): persisting high PCS. Higher levels of child internalizing behaviors and greater parental distress were associated with membership to the Severe Persistent group, relative to the Low Acute Recovered group. CONCLUSION This study indicates variability in postconcussive recovery according to 5 differential trajectories, with groups distinguished by the number of reported symptoms, levels of child internalizing behavior problems, and parental psychological distress. Identification of differential recovery trajectories may allow for targeted early intervention for children at risk of poorer outcomes.
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Lee, Lynn, Lin Fei, Jennifer Pope, and Lars M. Wagner. "Early Lymphocyte Recovery and Outcome in Osteosarcoma." Journal of Pediatric Hematology/Oncology 39, no. 3 (April 2017): 179–83. http://dx.doi.org/10.1097/mph.0000000000000717.
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Glynn, Ted, N. Bethune, T. Crooks, K. Ballard, and J. Smith. "Reading Recovery in Context: implementation and outcome." Educational Psychology 12, no. 3-4 (January 1992): 249–61. http://dx.doi.org/10.1080/0144341920120308.
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Mure, Pierre-Yves, Mark Galdo, and Nathalie Compagnone. "Bladder function after incomplete spinal cord injury in mice: quantifiable outcomes associated with bladder function and efficiency of dehydroepiandrosterone as a therapeutic adjunct." Journal of Neurosurgery: Spine 100, no. 1 (January 2004): 56–61. http://dx.doi.org/10.3171/spi.2004.100.1.0056.
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Object. The authors conducted a study to establish outcomes associated with bladder function in a mouse model of spinal cord injury (SCI) and to assess the sensitivity of these outcomes in determining the efficacy of pharmacological treatments. Methods. A mouse model of moderate contusive SCI was used. Outcome parameters included physiological, behavioral, and morphological measurements. To test the sensitivity of these outcomes, the authors used a dehydroepiandrosterone (DHEA) treatment that they had previously shown to promote neurological recovery effectively after SCI. A behavioral scale was used to identify the day at which autonomic function of the bladder was recovered. The reduction in the daily volume of urine during the period of functional recovery paralleled this scale. They then determined the day postinjury at which the functional differences between the vehicle- and DHEA-treated mice exhibited the maximal amplitude. Changes were measured in the composition of the extracellular matrix relative to collagen expression in the layer muscularis of the detrusor at this time point. They found that SCI increases the ratio of collagen type III to collagen type I in the detrusor. Moreover, in the DHEA-treated group, this ratio was similar to that demonstrated in sham-operated mice, establishing the sensitivity of this outcome to assess therapeutic benefits to the bladder function. They next examined the relationship between measurements of neurological recovery and controlled voiding by using cluster analysis. Conclusions. The authors found that early recovery of controlled voiding is predictive of motor recovery.
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Booker, James. "Predicting Recovery After Mild TBI." Neurosurgery 84, no. 5 (March 23, 2019): E274. http://dx.doi.org/10.1093/neuros/nyz001.nt1.
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Abstract INTRODUCTION Mild Traumatic Brain Injury (MTBI) is often treated as a homogenous group in current practice. Stratifying patients more accurately may result in the implementation of more effective, individualized treatment. We aimed to identify prognostic indicators of recovery 1-yr following MTBI. METHODS Using a prospective, observational study design, a large MTBI population (N = 596) was recruited following admission to the Emergency Department. Data was collected at brain injury clinics between August 2011 and July 2015. Functional recovery at 1-yr was assessed using the Glasgow Outcome Scale-Extended (GOSE). RESULTS A follow-up rate of 92% was achieved. The most common aetiologies of MTBI were falls (n = 222) and road traffic collisions (n = 154). Distribution of Glasgow Coma Scale (GCS) was 15 (n = 363), 14 (n = 156) and 13 (n = 77). Multiordinal logistic regression of the GOSE found that psychiatric history (P < .001), alcohol intoxication (P = .011), assault (P = .022) and GCS <15 (P = < .001), led to worse outcome. An abnormal CT scan was not a predictor of functional recovery. CONCLUSION Our findings indicate that after MTBI, patients with previous psychiatric history, GCS <15, aetiology of assault and alcohol intoxication result in worse long-term outcomes. Future work into developing a full prognostic model for MTBI may help to tailor individual treatment and improve long-term outcomes.
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Chen, Peng R., Sepideh Amin-Hanjani, Felipe C. Albuquerque, Cameron McDougall, Joseph M. Zabramski, and Robert F. Spetzler. "Outcome of Oculomotor Nerve Palsy from Posterior Communicating Artery Aneurysms: Comparison of Clipping and Coiling." Neurosurgery 58, no. 6 (June 1, 2006): 1040–46. http://dx.doi.org/10.1227/01.neu.0000215853.95187.5e.
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Abstract OBJECTIVE: Recovery of posterior communicating artery aneurysm-induced oculomotor nerve palsy (ONP) after aneurysm coiling has been reported. However, the coil mass may compromise recovery of the nerve. Therefore, we compared the outcome of coiling and clipping for this indication. METHODS: We retrospectively compared the outcomes of ONP in 13 patients, six of whom underwent endovascular coiling and seven of whom underwent surgical clipping. RESULTS: Six of the seven surgical patients with ONP recovered completely, compared with two of the six patients in the endovascular group. Of the patients with more than 1 year of follow-up, all six surgical patients recovered completely, compared with two of four endovascular patients (P = 0.05). In addition, preoperative complete or partial ONP also was associated with degree of resolution by survival analysis (P = 0.03). All patients with partial ONP in the surgical group and two of three patients in the endovascular group recovered without residual deficits, whereas three of the four patients with complete ONP in the clipping group and none in the coiling group recovered completely. Regardless of the treatment method, time to complete resolution of ONP was 6 months in both groups. CONCLUSION: Clipping posterior communicating artery aneurysms was associated with a higher probability of complete recovery from ONP than coiling. Degree of preoperative ONP also affected recovery. If patients can tolerate surgery, it should be considered the treatment of choice.
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Cai, Zhigang, Guangyan Yu, Daquan Ma, Jing Tan, Zhaohui Yang, and Xiaoming Zhang. "Experimental studies on traumatic facial nerve injury." Journal of Laryngology & Otology 112, no. 3 (March 1998): 243–47. http://dx.doi.org/10.1017/s002221510015827x.
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AbstractPurpose The purpose of this study was to investigate the outcome of different injuries to the facial nerve.Materials and methods Six patterns of injuries (exposure, compression, crushing, stretching, division and post-division anastomosis) were produced in the buccal branches of the facial nerve in 60 rabbits. Electroneuronography (ENoG) and histology at definite time were used to evaluate the results.Results and conclusions Exposure and compression injuries produced a neuropraxic injury and rapid recovery. Crushing and stretching injuries resulted in axonotmesis and whilst complete recovery can take place it may be very slow. Division and post-division anastomosis fall into neurotmesis injury and do not completely recover within six months; the former recovers slower and later than the latter.
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Massicotte, Sara, Ronda Lun, Vignan Yogendrakumar, Brian Dewar, Alexandra Davies, Dean A. Fergusson, Michel Shamy, and Dar Dowlatshahi. "Natural history of recovery after intracerebral haemorrhage: a scoping review protocol." BMJ Open 10, no. 8 (August 2020): e039460. http://dx.doi.org/10.1136/bmjopen-2020-039460.
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IntroductionClinical trials for intracerebral haemorrhage typically measure outcomes in the same way and at the same time points as trials for ischaemic stroke. However, there is growing evidence that the trajectory of recovery following intracerebral haemorrhage may differ significantly from that following ischaemic stroke. A better understanding of current approaches to outcome assessment is essential to ensure that future trials examining treatments for intracerebral haemorrhage are designed appropriately.ObjectiveTo determine when and how outcomes are measured in patients with intracerebral haemorrhage.Methods and analysisWith the assistance of an information specialist, we will conduct a scoping review by searching MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Web of Science for prospective studies of adults with primary intracerebral haemorrhage and documented outcomes with specified times. Two reviewers will independently collect data on included studies pertaining to publication data, study population information, timing of outcome and details of the outcome measurement tools used. The extracted data will be used to demonstrate the type and timing of outcome measures.Ethics and disseminationPrimary data will not be collected therefore formal ethics is not required. The findings of this study will be disseminated through peer-reviewed publications and through presentation at academic conferences.
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Dhanaraju, S., and N. Kannan. "Surgical outcome of prognostic factors for final outcome of hand function following primary median nerve repair." International Surgery Journal 5, no. 11 (October 26, 2018): 3672. http://dx.doi.org/10.18203/2349-2902.isj20184642.
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Background: A major problem in surgery of median nerve injuries is the unpredictable final outcome, so identifying the prognostic factors for final outcome is needed in primary median nerve repair following injury. Assessing the functional recovery of hand function following median nerve repair.Methods: Total no. of patients with median nerve injury repaired in our institution was 70. All the patients assessed preoperatively by clinical examination, surgery performed immediately or within 12 hours of injury, performed under axillary block and tourniquet control, Multiple surgeons involved (about 6 surgeons). All are primarily repaired nerves, repair by 70 prolene epineural sutures, postoperative immobilization of 3 weeks.Results: Median nerve injury associated with other flexors involved patients show good functional recovery, the functional recovery deteriorate once involvement of finger flexors, particularly if all the tendons were injured. The arterial injury and repair don’t seem to influence the outcome of the hand function, but both artery involvement usually associated with all tendon injury, it shows poor outcome.Conclusions: The more distal the injury the outcome will be quicker as compared to middle 1/3 and proximal 1/3 injuries. Pure median nerve injuries sensory recovery in S4 grade about 5%, S3+ recovery of sensation is about 36%. Pure median nerve injury patients M4 motor recovery about 54%.Only median nerve injury the final outcome is good but combined median and ulnar nerve injury and associated tendon injury the outcome is poor.
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Shah, S. K., S. J. Harasymiw, and P. L. Stahl. "Stroke Rehabilitation: Outcome Based on Brunnstrom Recovery Stages." Occupational Therapy Journal of Research 6, no. 6 (November 1986): 365–76. http://dx.doi.org/10.1177/153944928600600604.
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Rehabilitation outcome based on Brunnstrom recovery stages following comprehensive rehabilitation was examined for a sample of 98 inpatients with cerebrovascular accident and resulting hemiplegia or hemiparesis. Using admission and discharge dates retrieved from a computer-based patient information system, frequency distributions, cross-tabulations, and Spearman's correlations were computed. Regardless of severity of paralysis, length of stay, and time of admission from onset, patients tended to improve at all levels of recovery stages. The stage of recovery at admission seemed to set the probable upper limit on how far patients were likely to progress. The strong positive correlations between recovery at admission and discharge on all measures for arm, hand, and leg recovery, with or without proprioception, seem to indicate that recovery in hemiplegia is a global phenomenon.
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Skuse, David. "Recovery." International Psychiatry 9, no. 1 (February 2012): 3. http://dx.doi.org/10.1192/s1749367600002873.
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The concept of ‘recovery’ as applied to severe mental illness has fostered a cultural change in attitudes to the long-term outcome of conditions such as schizophrenia. ‘Recovery’ has a specific meaning in this context. It refers to the possibility that even in the presence of a chronic psychiatric disorder there is hope for a life that has value. The affected individual can still make a contribution to society; he or she can expect to live independently and with dignity. The term implies that our traditional medical model of illness lacks the longer-term perspective on how patients might learn to cope with their condition.
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Craven, Ann-Maree S., Carmel M. Hawley, Stephen P. McDonald, Johan B. Rosman, Fiona G. Brown, and David W. Johnson. "Predictors of Renal Recovery in Australian and New Zealand end-Stage Renal Failure Patients Treated with Peritoneal Dialysis." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 27, no. 2 (March 2007): 184–91. http://dx.doi.org/10.1177/089686080702700216.
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Objectives The aim of this study was to investigate the factors affecting recovery and durability of dialysis-independent renal function following commencement of peritoneal dialysis (PD). Design Retrospective, observational cohort study of the Australian and New Zealand PD patient population. Setting Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Participants The study reviewed all patients in Australia and New Zealand who commenced PD for treatment of end-stage renal failure between 15 May 1963 and 31 December 2004. Main Outcome Measures The primary outcomes examined were recovery of dialysis-independent renal function and time from PD commencement to recovery of renal function. A secondary outcome measure was time to renal death (patient death or recommencement of renal replacement therapy) following recovery of dialysis-independent renal function. Results 24663 patients commenced PD during the study period. Of these, 253 (1%) recovered dialysis-independent renal function. An increased likelihood of recovery was predicted by autoimmune renal disease, hemolytic-uremic syndrome, paraproteinemia, cortical necrosis, renovascular disease, and treatment in New Zealand. A reduced likelihood of recovery was associated with polycystic kidney disease and indigenous race. Analysis of a contemporary subset of 14743 patients in whom complete data were available for body mass index, smoking, and comorbidities yielded comparable results, except that increasing age was additionally associated with a decreased likelihood of recovery. Of the 253 patients who recovered renal function, 151 (60%) recommenced renal replacement therapy and 49 (19%) died within a median period of 226 days (interquartile range 110 – 581 days). The only significant predictors of continued renal survival after renal recovery were autoimmune renal disease and cortical necrosis. Conclusions Recovery of renal function in patients treated with PD is rare and determined mainly by renal disease type and race. In the majority of cases, recovery is short term. The apparently high rate of early patient death or return to dialysis after recovery of renal function on PD raises questions about the appropriateness of discontinuing PD therapy under such circumstances.
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Ferguson, Sue A. "Longitudinal Observations of Low Back Pain Recovery." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 42, no. 14 (October 1998): 1013–17. http://dx.doi.org/10.1177/154193129804201402.
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Most low back pain recovery studies evaluate one outcome measure at one point in time. Return to work, symptoms, activities of daily living and functional performance have been commonly used outcome measures. The goal of this project was to evaluate all four previously used outcome measures at several points in time. The second goal of the project was to predict outcome as a function of time and recovery measure. The outcome measures of working status, symptoms, and activities of daily living were measured using questionnaires. Functional performance outcome was evaluated using the lumbar motion monitor. These outcome measures were evaluated every two weeks for three months. Psychological factors, psychosocial factors, physical job demands and personal factors that may influence recovery were also evaluated. Discriminant function analysis was used to predict outcome at a specific visit given the confounding factors and any previous conditions. The cross-validation error rate for the discriminant function results ranged from 0–15%. The results showed discrepancies among the four outcome measures in there indication of recovery. This is the first study to compare multiple outcome measures at several point in time after an LBP episode.
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Barrenger, Stacey L., Victoria Stanhope, and Emma Miller. "Capturing the value of peer support: measuring recovery-oriented services." Journal of Public Mental Health 18, no. 3 (September 5, 2019): 180–87. http://dx.doi.org/10.1108/jpmh-02-2019-0022.
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Purpose The purpose of this paper is to examine the gap between recovery-oriented processes and clinical outcomes in peer support, an exemplar of recovery-oriented services, and offer suggestions for bridging this gap. Design/methodology/approach This viewpoint is a brief review of literature on peer support services and gaps in outcome measurement towards building an evidence base for recovery-oriented services. Findings Clinical outcomes like hospitalizations or symptoms remain a focus of research, practice and policy in recovery-oriented services and contribute to a mixed evidence base for peer support services, in which recovery-oriented outcomes like empowerment, self-efficacy and hopefulness have more evidentiary support. One approach is to identify the theoretical underpinnings of peer support services and the corresponding change mechanisms in models that would make these recovery-oriented outcomes mediators or process outcomes. A better starting point is to consider which outcomes are valued by the people who use services and develop an evaluation approach according to those stated goals. User driven measurement approaches and more participatory types of research can improve both the quality and impact of health and mental health services. Originality/value This viewpoint provides a brief review of peer support services and the challenges of outcome measurement in establishing an evidence base and recommends user driven measurement as a starting point in evaluation of recovery-oriented services.
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Dietz, Robert M., James E. Orfila, Krista M. Rodgers, Olivia P. Patsos, Guiying Deng, Nicholas Chalmers, Nidia Quillinan, Richard J. Traystman, and Paco S. Herson. "Juvenile cerebral ischemia reveals age-dependent BDNF–TrkB signaling changes: Novel mechanism of recovery and therapeutic intervention." Journal of Cerebral Blood Flow & Metabolism 38, no. 12 (April 3, 2018): 2223–35. http://dx.doi.org/10.1177/0271678x18766421.
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Global ischemia in childhood often leads to poor neurologic outcomes, including learning and memory deficits. Using our novel model of childhood cardiac arrest/cardiopulmonary resuscitation (CA/CPR), we investigate the mechanism of ischemia-induced cognitive deficits and recovery. Memory is impaired seven days after juvenile CA/CPR and completely recovers by 30 days. Consistent with this remarkable recovery not observed in adults, hippocampal long-term potentiation (LTP) is impaired 7–14 days after CA/CPR, recovering by 30 days. This recovery is not due to the replacement of dead neurons (neurogenesis), but rather correlates with brain-derived neurotrophic factor (BDNF) expression, implicating BDNF as the molecular mechanism underlying impairment and recovery. Importantly, delayed activation of TrkB receptor signaling reverses CA/CPR-induced LTP deficits and memory impairments. These data provide two new insights (1) endogenous recovery of memory and LTP through development may contribute to improved neurological outcome in children compared to adults and (2) BDNF-enhancing drugs speed recovery from pediatric cardiac arrest during the critical school ages.
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Hergenroeder, Albert C., Constance M. Wiemann, Christopher Henges, and Amanda Dave. "Outcome of adolescents with eating disorders from an adolescent medicine service at a large children’s hospital." International Journal of Adolescent Medicine and Health 27, no. 1 (February 1, 2015): 49–56. http://dx.doi.org/10.1515/ijamh-2013-0341.
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Abstract Objective: To describe outcomes of adolescents with eating disorders treated by an interdisciplinary adolescent medicine service at a large children’s hospital and to identify factors, including hospitalization, associated with outcome. Design: The study design was a retrospective chart review of patients. Setting: The setting was an inpatient and outpatient adolescent service in a large urban children’s hospital. Participants: A total of 218 adolescents diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified participated in the study. Intervention: Interdisciplinary inpatient and outpatient treatment for eating disorders was adopted for intervention. Outcome measures: Patient outcomes were categorized as fully recovered, partially recovered/improved, or poorly recovered/exhibiting chronicity. Results: Being admitted to the study hospital once and longer duration of follow-up were associated with full or partial recovery. In contrast, being readmitted to the study hospital and longer duration of illness prior to the initial contact with this service were associated with poor recovery. Premorbid obesity was unrelated to outcome. Conclusions: Earlier detection and referral of adolescents with eating disorders are needed because a high percentage of patients, especially those with anorexia nervosa, required hospitalization at initial contact. The benefits of inpatient admission may extend beyond medical stabilization of the most medically compromised patients to include improved therapeutic relationship with the treatment team and improved follow-up. Many patients prematurely terminate treatment; factors contributing to premature termination of therapy need further exploration.
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Parker, Gordon, Kay Wilhelm, Philip Mitchell, and Gemma Gladstone. "Predictors of 1-Year Outcome in Depression." Australian & New Zealand Journal of Psychiatry 34, no. 1 (February 2000): 56–64. http://dx.doi.org/10.1046/j.1440-1614.2000.00698.x.
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Objective: We compared several different methods for assessing depression ‘recovery’ over a 1-year review interval, to determine the utility of the contrasting approaches. Second, we assessed baseline predictors of 1-year outcome and recovery status. Third, we examined the extent to which predictors showed consistency across the variable definitions of outcome and recovery. Methods: Twelve-month outcome was assessed in a sample of 182 subjects who at baseline assessment met DSM criteria for a major depressive episode. The contrasting methods involved a defined percentage reduction in Beck Depression Inventory self-rating scores, formalised change point definitions, no longer meeting DSM-IV major depression criteria, and clinical global improvement (CGI) ratings. Results: Sixty-one per cent reached formalised change point criteria for full remission or recovery when trajectories across the 12-month interval were examined. Other measures quantified recovery rates ranging from 43% to 70%. Those with a psychotic or melancholic depression were more likely to have achieved recovery status in some analyses. Non-recovery at 12 months was predicted most consistently by higher baseline levels of anxiety and depression; high trait anxiety and a lifetime anxiety disorder; disordered personality function; and having reported exposure to acute and enduring stressors at baseline assessment. Conclusions: While the CGI was the superior system in terms of number of significant discriminating predictors of outcome, the change point definitional approach provides much greater information across the follow-up interval, arguing for their complementary utility. As several currently identified baseline predictors of outcome (i.e. anxiety, disordered personality function) also predicted onset of depression, their relevance as both depression-inducing and depression-propagating variables is suggested.
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Wong, Alex Mun-Ching, Chih-Hua Yeh, Jainn-Jim Lin, I.-Jun Chou, and Kuang-Lin Lin. "Rhombencephalitis in Children: Diffusion Magnetic Resonance Imaging (MRI) Correlation With Clinical Outcomes." Journal of Child Neurology 35, no. 6 (March 3, 2020): 404–9. http://dx.doi.org/10.1177/0883073820904480.
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In children with rhombencephalitis, neuroimaging abnormalities have been infrequently correlated with clinical outcome. We investigated whether magnetic resonance (MR) neuroimaging studies could predict clinical outcomes and disturbance of consciousness in patients with rhombencephalitis. We retrospectively analyzed the MR studies of 19 pediatric patients with rhombencephalitis (median age: 4.2 years, range 0.5-17; sex: 32% male). Fluid-attenuated inversion recovery imaging and diffusion-weighted imaging findings were graded to create imaging scores according to the extent of imaging abnormality. Clinical outcomes in the first week and 12th month were graded by using Glasgow Outcome Scale scores (1-5) and dichotomized to unfavorable or favorable outcome. Correlations of the imaging scores with the clinical outcomes and with disturbance of consciousness were assessed by using multivariate logistic regression analysis. No significant correlation was found between fluid-attenuated inversion recovery score or diffusion-weighted imaging score ( P = .608, P = .132, respectively) and disturbance of consciousness. In the first week, the unfavorable outcome group (n = 11) had significantly higher diffusion-weighted imaging score than did the favorable outcome group (n = 8) (Mann-Whitney U test, P = .005). Multivariate logistic regression analysis showed that the diffusion-weighted imaging score (odds ratio, 18.182; 95% confidence interval: 1.36, 243.01; P = .028) was significantly associated with unfavorable outcome. In the 12th month, the fluid-attenuated inversion recovery score or diffusion-weighted imaging score ( P = .994, P = .997, respectively) were not significantly associated with unfavorable outcome. Patients with rhombencephalitis who have a higher diffusion-weighted imaging score are more likely to have an unfavorable 1-week clinical outcome.
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Saaka, Mahama, Shaibu Mohammed Osman, Anthony Amponsem, Juventus B. Ziem, Alhassan Abdul-Mumin, Prosper Akanbong, Ernestina Yirkyio, Eliasu Yakubu, and Sean Ervin. "Treatment Outcome of Severe Acute Malnutrition Cases at the Tamale Teaching Hospital." Journal of Nutrition and Metabolism 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/641784.
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Objective.This study investigated the treatment outcomes and determinant factors likely to be associated with recovery rate.Methods.A retrospective chart review (RCR) was performed on 348 patients who were enrolled in the outpatient care (OPC) during the study period.Results.Of the 348 cases, 33.6% recovered (having MUAC≥125 mm), 49.1% defaulted, and 11.5% transferred to other OPC units to continue with treatment. There were 187 (53.7%) males and 161 (46.3%) females with severe malnutrition. The average weight gain rate was 28 g/kg/day. Controlling for other factors, patients who completed the treatment plan had 3.2 times higher probability of recovery from severe acute malnutrition (SAM) as compared to patients who defaulted (adjusted odds ratio (AOR) = 3.2, 95% CI = 1.9, 5.3, andp<0.001). The children aged 24–59 months had 5.8 times higher probability of recovery from SAM as compared to children aged 6–11 months (AOR = 5.8, 95% CI = 2.5, 10.6, andp<0.001).Conclusions.Cure rate was low and the default rate was quite high. Children who were diagnosed as having marasmus on admission stayed longer before recovery than their kwashiorkor counterparts. Younger children were of greater risk of nonrecovery.
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Levin, Harvey S., Howard E. Gary, Howard M. Eisenberg, Ronald M. Ruff, Jeffrey T. Barth, Jeffrey Kreutzer, Walter M. High, et al. "Neurobehavioral outcome 1 year after severe head injury." Journal of Neurosurgery 73, no. 5 (November 1990): 699–709. http://dx.doi.org/10.3171/jns.1990.73.5.0699.
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✓ The outcome 1 year after they had sustained a severe head injury was investigated in patients who were admitted to the neurosurgery service at one of four centers participating in the Traumatic Coma Data Bank (TCDB). Of 300 eligible survivors, the quality of recovery 1 year after injury was assessed by at least the Glasgow Outcome Scale (GOS) in 263 patients (87%), whereas complete neuropsychological assessment was performed in 127 (42%) of the eligible survivors. The capacity of the patients to undergo neuropsychological testing 1 year after injury was a criterion of recovery as reflected by a significant relationship to neurological indices of acute injury and the GOS score at the time of hospital discharge. The neurobehavioral data at 1 year after injury were generally comparable across the four samples of patients and characterized by impairment of memory and slowed information processing. In contrast, language and visuospatial ability recovered to within the normal range. The lowest postresuscitation Glasgow Coma Scale (GCS) score and pupillary reactivity were predictive of the 1-year GOS score and neuropsychological performance. The lowest GCS score was especially predictive of neuropsychological performance 1 year postinjury in patients who had at least one nonreactive pupil following resuscitation. Notwithstanding limitations related to the scope of the TCDB and attrition in follow-up material, the results indicate a characteristic pattern of neurobehavioral recovery from severe head injury and encourage the use of neurobehavioral outcome measurements in clinical trials to evaluate interventions for head-injured patients.
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Woo, M.D, Kam S., and Harvey D. White, M.B. "FACTORS AFFECTING OUTCOME AFTER RECOVERY FROM MYOCARDIAL INFARCTION." Annual Review of Medicine 45, no. 1 (February 1994): 325–39. http://dx.doi.org/10.1146/annurev.med.45.1.325.
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Levin, Aaron. "Brain Response After Trauma May Predict Recovery Outcome." Psychiatric News 43, no. 20 (October 17, 2008): 23. http://dx.doi.org/10.1176/pn.43.20.0023.
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Balkaya, Mustafa, and Sunghee Cho. "Optimizing functional outcome endpoints for stroke recovery studies." Journal of Cerebral Blood Flow & Metabolism 39, no. 12 (September 14, 2019): 2323–42. http://dx.doi.org/10.1177/0271678x19875212.
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Novel therapeutic intervention that aims to enhance the endogenous recovery potential of the brain during the subacute phase of stroke has produced promising results. The paradigm shift in treatment approaches presents new challenges to preclinical and clinical researchers alike, especially in the functional endpoints domain. Shortcomings of the “neuroprotection” era of stroke research are yet to be fully addressed. Proportional recovery observed in clinics, and potentially in animal models, requires a thorough reevaluation of the methods used to assess recovery. To this end, this review aims to give a detailed evaluation of functional outcome measures used in clinics and preclinical studies. Impairments observed in clinics and animal models will be discussed from a functional testing perspective. Approaches needed to bridge the gap between clinical and preclinical research, along with potential means to measure the moving target recovery, will be discussed. Concepts such as true recovery of function and compensation and methods that are suitable for distinguishing the two are examined. Often-neglected outcomes of stroke, such as emotional disturbances, are discussed to draw attention to the need for further research in this area.
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Thoresen, Marianne, and Damjan Osredkar. "Brain wave recovery predicts outcome after cardiac arrest." Resuscitation 84, no. 2 (February 2013): 145–46. http://dx.doi.org/10.1016/j.resuscitation.2012.11.026.
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Thompson, Katherine N., Patrick D. McGorry, and Susan M. Harrigan. "Recovery style and outcome in first-episode psychosis." Schizophrenia Research 62, no. 1-2 (July 2003): 31–36. http://dx.doi.org/10.1016/s0920-9964(02)00428-0.
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Andresen, Retta, Peter Caputi, and Lindsay G. Oades. "Do clinical outcome measures assess consumer-defined recovery?" Psychiatry Research 177, no. 3 (May 2010): 309–17. http://dx.doi.org/10.1016/j.psychres.2010.02.013.
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Michaels, A. J., C. E. Michaels, J. J. Smith, C. H. Moon, and C. Peterson. "Mental Health Outcome Limits Recovery in Burned Adults." Journal of Burn Care & Rehabilitation 21 (January 2000): S253. http://dx.doi.org/10.1097/00004630-200001001-00237.
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Jobe, Thomas H., and Martin Harrow. "Schizophrenia Course, Long-Term Outcome, Recovery, and Prognosis." Current Directions in Psychological Science 19, no. 4 (August 2010): 220–25. http://dx.doi.org/10.1177/0963721410378034.
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Griffiths, Mary, Sean A. Kidd, Shannon Pike, and Jacky Chan. "The Tobacco Addiction Recovery Program: Initial Outcome Findings." Archives of Psychiatric Nursing 24, no. 4 (August 2010): 239–46. http://dx.doi.org/10.1016/j.apnu.2009.07.003.
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Sviri, Gill E., Rune Aaslid, Colleen M. Douville, Anne Moore, and David W. Newell. "Time course for autoregulation recovery following severe traumatic brain injury." Journal of Neurosurgery 111, no. 4 (October 2009): 695–700. http://dx.doi.org/10.3171/2008.10.17686.
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Object The aim of the present study was to evaluate the time course for cerebral autoregulation (AR) recovery following severe traumatic brain injury (TBI) Methods Thirty-six patients (27 males and 9 females, mean ± SEM age 33 ± 15.1 years) with severe TBI underwent serial dynamic AR studies with leg cuff deflation as a stimulus, until recovery of the AR responses was measured. Results The AR was impaired (AR index < 2.8) in 30 (83%) of 36 patients on Days 3–5 after injury, and in 19 individuals (53%) impairments were found on Days 9–11 after the injury. Nine (25%) of 36 patients exhibited a poor AR response (AR index < 1) on postinjury Days 12–14, which eventually recovered on Days 15–23. Fifty-eight percent of the patients with a Glasgow Coma Scale score of 3–5, 50% of those with diffuse brain injury, 54% of those with elevated intracranial pressure, and 40% of those with poor outcome had no AR recovery in the first 11 days after injury. Conclusions Autoregulation recovery after severe TBI can be delayed, and failure to recover during the 2nd week after injury occurs mainly in patients with a lower Glasgow Coma Scale score, diffuse brain injury, elevated ICP, or unfavorable outcome. The finding suggests that perfusion pressure management should be considered in some of the patients for a period of at least 2 weeks.
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CARROLL, LINDA J., LENA W. HOLM, ROBERT FERRARI, DEJAN OZEGOVIC, and J. DAVID CASSIDY. "Recovery in Whiplash-Associated Disorders: Do You Get What You Expect?" Journal of Rheumatology 36, no. 5 (February 17, 2009): 1063–70. http://dx.doi.org/10.3899/jrheum.080680.
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Objective.Positive expectations predict better outcome in a number of health conditions, but the role of expectations in predicting health recovery after injury is not well understood. We investigated whether early expectations of recovery in whiplash associated disorders (WAD) predict subsequent recovery, and studied the role of “expectations” to predict recovery as determined by pain cessation and resolution of pain-related limitations in daily activities.Methods.A cohort of 6,015 adults with traffic-related whiplash injuries was assessed, using multivariable Cox proportional hazards analysis, for association between these expectations and self-perceived recovery over a 1-year period following the injury. Recovery was assessed using 3 indices: self-perceived global recovery (primary outcome); resolution of neck pain severity; and resolution of pain-related limitations in daily activities.Results.After adjusting for the effect of sociodemographic characteristics, post-crash symptoms and pain, prior health status and collision-related factors, those who expected to get better soon recovered over 3 times as quickly (hazard rate ratio = 3.62, 95% confidence interval 2.55–5.13) as those who expected that they would never get better. Findings were similar for resolution of pain-related limitations and resolution of neck pain intensity, although the effect sizes for the latter outcome were smaller.Conclusion.Patients’ early expectations for recovery are an important prognostic factor in recovery after whiplash injury, and are potentially modifiable. Clinicians should assess these expectations in order to identify those patients at risk of chronic whiplash, and future studies should focus on the effect of changing these early expectations.
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Sun, Jing, Zheng Ke, Shea Ping Yip, Xiao-ling Hu, Xiao-xiang Zheng, and Kai-yu Tong. "Gradually Increased Training Intensity Benefits Rehabilitation Outcome after Stroke by BDNF Upregulation and Stress Suppression." BioMed Research International 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/925762.
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Physical training is necessary for effective rehabilitation in the early poststroke period. Animal studies commonly use fixed training intensity throughout rehabilitation and without adapting it to the animals' recovered motor ability. This study investigated the correlation between training intensity and rehabilitation efficacy by using a focal ischemic stroke rat model. Eighty male Sprague-Dawley rats were induced with middle cerebral artery occlusion/reperfusion surgery. Sixty rats with successful stroke were then randomly assigned into four groups: control (CG,n=15), low intensity (LG,n=15), gradually increased intensity (GIG,n=15), and high intensity (HG,n=15). Behavioral tests were conducted daily to evaluate motor function recovery. Stress level and neural recovery were evaluated via plasma corticosterone and brain-derived neurotrophic factor (BDNF) concentration, respectively. GIG rats significantly (P<0.05) recovered motor function and produced higher hippocampal BDNF (112.87 ± 25.18 ng/g). GIG and LG rats exhibited similar stress levels (540.63 ± 117.40 nM/L and 508.07 ± 161.30 nM/L, resp.), which were significantly lower (P<0.05) than that (716.90 ± 156.48 nM/L) of HG rats. Training with gradually increased intensity achieved better recovery with lower stress. Our observations indicate that a training protocol that includes gradually increasing training intensity should be considered in both animal and clinical studies for better stroke recovery.
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Hsieh, Pei-Ju, and Han-Tsung Liao. "Outcome Analysis of Surgical Timing in Pediatric Orbital Trapdoor Fracture with Different Entrapment Contents: A Retrospective Study." Children 9, no. 3 (March 11, 2022): 398. http://dx.doi.org/10.3390/children9030398.
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Orbital trapdoor fracture occurs more commonly in pediatric patients, and previous studies suggested early intervention for a better outcome. However, there is no consensus on the appropriate timing of emergent intervention due to the insufficient cases reported. In the current retrospective study, we compared the outcomes of patient groups with different time intervals from injury to surgical intervention and entrapment content. Twenty-three patients who underwent surgery for trapdoor fracture between January 2001 and September 2018 at Chang Gung Memorial Hospital were enrolled. There was no significant difference in diplopia and extraocular muscle (EOM) movement recovery rate in patients who underwent surgery within three days and those over three days. However, among the patients with an interval to surgery of over three days, those with muscle entrapment required a longer period of time to recover from EOM movement restriction (p = 0.03) and diplopia (p = 0.03) than those with soft tissue entrapment. Regardless of time interval to surgery, patients with muscle entrapment took longer time to recover from EOM movement restriction (p = 0.036) and diplopia (p = 0.042) and had the trend of a worse EOM recovery rate compared to patients with soft tissue entrapment. Hence, we suggested that orbital trapdoor fractures with rectus muscle entrapment should be promptly managed for faster recovery.
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Harms, James, Ayaz Khawaja, Maria Taylor, Xiaosi Han, and Michal Mrug. "Recovery of methotrexate-induced anuric acute kidney injury after glucarpidase therapy." SAGE Open Medical Case Reports 5 (January 1, 2017): 2050313X1770505. http://dx.doi.org/10.1177/2050313x17705050.
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Objectives: This case report describes two cases of high-dose methotrexate–induced nephrotoxicity: death in the case of conventional supportive care and successful renal function recovery in a patient treated with glucarpidase and continuous dialysis. Methods: High dose methotrexate is widely used for management of adult and pediatric malignancies. However, high-dose methotrexate–induced renal nephrotoxicity may cause severe, even lethal complications. Here we present examples of such outcomes. Results: We present one case of lethal high-dose methotrexate nephrotoxicity in a patient treated with conventional rescue therapy. We contrast this outcome with another patient with high-dose methotrexate–induced anuric acute kidney injury, who has recovered renal function following therapy with glucarpidase and continuous dialysis. Conclusions: This is only the second reported case of high-dose methotrexate–induced anuric acute kidney injury, and the only one with a reported clinical outcome. This first report of recovery from high-dose methotrexate–induced anuric acute kidney injury after glucarpidase administration supports available evidence pointing to the effectiveness of this therapy.
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Paudel, Byapak, Harvinder Singh Chhabra, Rabindra Lal Pradhan, and Mohit Arora. "Outcome of Surgical Decompression in Simple Degenerative Lumbar Canal Stenosis." Nepal Orthopaedic Association Journal 3, no. 2 (January 5, 2014): 2–9. http://dx.doi.org/10.3126/noaj.v3i2.9512.
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Introduction: A sensory or motor deficit occurs in about half of patients with symptomatic lumbar canal stenosis. There is no study evaluating neurologically deficient patients with simple degenerative lumbar canal stenosis using validated measures and there are no consensus about outcome predictor of surgical decompression is available in literature. Only one study assessed outcome of patients with neurological deficit but it had not excluded either patients with comorbid conditions that affect outcome or those with lumbar canal stenosis secondary to spondylolisthesis and scoliosis. The aim of this study was to assess overall result and to compare the surgically treated patients of simple degenerative lumbar canal stenosis using validated outcome measures like Oswestry Disability Scale (ODS), Neurogenic Claudication Score (NCS), Visual Analogue Scale (VAS) and Satisfaction, this study also aimed to find outcome predictor of surgical decompression. Methods: This was a retrospective comparative study with homogenous cohorts with control of comorbid conditions that affect outcome. Each cohort ( Those with neurological deficit and without neurological deficit) had 11 patients who had adequate decompression with laminectomy and foraminotomies. Outcome was evaluated using validated ODS, NCS, VAS and Satisfaction in overall and also evaluated by each section of ODS, NCS with appropriate statistical analysis of both cohorts. Results: Neurologically deficient patients had more back pain, tingling, numbness, weakness and heaviness preoperatively. In neurologically deficient patients there was a trend to have poorer outcome, but overall recovery rate was higher than neurologically normal patients. Sensory deficit did not recover. The index surgery may not have effect on sitting and sleeping in both cohorts and may not have effect on lifting in neurologically normal patients and may not have effect on social life in neurological deficient patients. Additionally the index surgery may not have effect in relieving symptoms of numbness, tingling and heaviness and weakness in neurologically normal patients and may not have effect on standing in both cohorts. Recovery according to VAS was higher in neurologically normal patients. Preoperative NCS and preoperative heaviness and weakness severity contributed up to 43 % in ODS recovery rate. Conclusion: Overall there is a trend to have poorer outcome in neurologically deficient patients though recovery rate is better than neurologically normal patients. Recovery in term of VAS is better in neurologically normal patients. Preoperative NCS and preoperative heaviness and weakness severity score predict or contribute up to 43 % in ODS recovery rate. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9512 NOAJ July-December 2013, Vol 3, Issue 2, 2-9
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Klassen, Tara D., Sean P. Dukelow, Mark T. Bayley, Oscar Benavente, Michael D. Hill, Andrei Krassioukov, Teresa Liu-Ambrose, et al. "Determining optimal poststroke exercise: Study protocol for a randomized controlled trial investigating therapeutic intensity and dose on functional recovery during stroke inpatient rehabilitation." International Journal of Stroke 14, no. 1 (July 16, 2018): 80–86. http://dx.doi.org/10.1177/1747493018785064.
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Rationale A top priority in stroke rehabilitation research is determining the appropriate exercise dose to optimize recovery. Although more intensive rehabilitation very early after stroke may be deleterious to recovery, inpatient rehabilitation, occurring after acute care, may be a more appropriate setting to assess therapeutic dose on neurological recovery. Hypothesis Individuals receiving higher intensity and dose exercise programs will yield greater improvements in walking ability over usual inpatient physical therapy care. Methods and design Seventy-five individuals across seven inpatient rehabilitation sites in Canada will be randomized into one of three treatment programs, each 5 days/week, for four weeks and monitored for exertion (heart rate) and repetitions (step count). Study outcomes The primary outcome measure is the 6 min walk and secondary outcomes include functional independence, cognitive, and quality-of-life measures. Outcome data will be assessed at four time points. Summary This trial will contribute to our knowledge of the therapeutic intensity and dose necessary to maximize functional recovery at a very important stage of rehabilitation and neural recovery poststroke.
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Jang, Seung Hwa, Sang Gyu Kwak, and Min Cheol Chang. "Diabetes does not affect motor recovery after intracerebral hemorrhage." Translational Neuroscience 11, no. 1 (August 25, 2020): 277–82. http://dx.doi.org/10.1515/tnsci-2020-0125.
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AbstractBackgroundThis retrospective study evaluated whether diabetes affects motor outcome after stroke by analyzing the effects of diabetes on motor prognosis by controlling for critical factors, including lesion type and location, corticospinal tract (CST) state, patient age, lesion volume, and treatment method during the stroke.MethodologyWe recruited 221 patients with intracerebral hemorrhage (ICH) of the basal ganglia. We used diffusion tensor tractography to investigate the CST state. We also evaluated the hemorrhage volume. We obtained information on the presence of diabetes and age by chart review. Motor outcomes at 6 months were measured using the upper and lower limb motricity index (MI), modified Brunnstrom classification (MBC), and functional ambulation category (FAC). We used multiple linear regression tests to investigate whether diabetes affected motor outcomes after stroke after adjusting for other factors, including CST state, age, lesion volume, and treatment method.ResultsThe presence of diabetes was not correlated with motor outcome measurements, including upper and lower MIs, MBC, and FAC, at 6 months after the onset. However, the CST state, age, lesion volume, and treatment method were significantly correlated with nearly all motor outcomes.ConclusionsWe found that diabetes did not significantly affect motor outcomes after ICH.