Open AccessEffects of physiatrist and registered therapist operating acute rehabilitation (PROr) in patients with stroke
Author(s) -
Tokio Kinoshita,
Yukihide Nishimura,
Takeshi Nakamura,
Takamasa Hashizaki,
Daisuke Kojima,
Makoto Kawanishi,
Hiroyasu Uenishi,
Hidetoshi Arakawa,
Takahiro Ogawa,
Yoshi Ichiro Kamijo,
Takashi Kawasaki,
Fumihiro Tajima
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0187099
Subject(s) - medicine , functional independence measure , glasgow coma scale , rehabilitation , stroke (engine) , physical therapy , acute stroke , prospective cohort study , activities of daily living , surgery , emergency department , nursing , mechanical engineering , engineering
Objective Clinical evidence suggests that early mobilization of patients with acute stroke improves activity of daily living (ADL). The purpose of this study was to compare the utility of the p hysiatrist and r egistered therapist o perating acute r ehabilitation (PROr) applied early or late after acute stroke. Subjects and methods This study was prospective cohort study, assessment design. Patients with acute stroke (n = 227) admitted between June 2014 and April 2015 were divided into three groups based on the time of start of PROr: within 24 hours (VEM, n = 47), 24–48 hours (EM, n = 77), and more than 48 hours (OM, n = 103) from stroke onset. All groups were assessed for the number of deaths during hospitalization, and changes in the Glasgow Coma Scale (GCS), National Institute of Health Stroke Scale (NIHSS), and Functional Independence Measure (FIM) at hospital discharge. Interventions All patients were assessed by physiatrists, who evaluated the specific needs for rehabilitation, and then referred them to registered physical therapists and occupational therapists to provide early mobilization (longer than one hour per day per patient). Results The number of deaths encountered during the PROr period was 13 (out of 227, 5.7%), including 2 (4.3%) in the VEM group. GCS improved significantly during the hospital stay in all three groups, but the improvement on discharge was significantly better in the VEM group compared with the EM and OM groups. FIM improved significantly in the three groups, and the gains in total FIM and motor subscale were significantly greater in the VEM than the other groups. Conclusions PROr seems safe and beneficial rehabilitation to improve ADL in patients with acute stroke.