Article

OBJECTIVE: To examine change and individual trajectories for balance, upper
extremity motor capacity, and mobility in people poststroke during the time they
received outpatient therapies. DESIGN: Retrospective analyses of an observational
cohort using hierarchical linear modeling. SETTING:
Outpatient rehabilitation.
PARTICIPANTS: Persons poststroke (N=366). INTERVENTIONS: Usual outpatient
physical and occupational therapy. MAIN OUTCOMES MEASURES: Berg Balance Scale
(BBS), Action Research Arm Test (ARAT), and walking speed were used to assess the
3 domains. Initial scores at the start of outpatient therapy (intercepts), rate
of change during outpatient therapy (slopes), and covariance between slopes and
intercepts were modeled as random effects. Additional variables modeled as fixed
effects were duration (months of outpatient therapy), time (days poststroke), age
(y), and inpatient status (if the patient went to an inpatient rehabilitation
facility [IRF]). RESULTS: A patient with average age and time started at 37
points on the BBS with a change of 1.8 points per month, at 35 points on the ARAT
with a change of 2 points per month, and with a walking speed of .59m/s with a
change of .09m/s per month. When controlling for other variables, patients
started with lower scores on the BBS and ARAT or had slower walking speeds at
admission if they started outpatient therapy later than average or went to an
IRF. CONCLUSIONS: Patients generally improved over the course of outpatient
therapy, but there was considerable variability in individual trajectories.
Average rates of change across all 3 domains were small.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS