1,721,007 research outputs found
Vita tua, mors mea: the experience of family caregivers of patients in a vegetative state
No full textIl gruppo come strumento della rieducazione cognitiva nei pazienti con esiti di trauma cranio-encefalico
No full text
Anosognosia per emiplegia: osservazione clinica e analisi delle lesioni per la progettazione dell'intervento riabilitativo
No full textL'ansognosia per emiplegia è un grave deficit che mette in discussione gli esiti del percorso riabilitativo. Una approfondita diagnosi clinica associata a uno studio di analisi lesionale è riportata su un gruppo di pazienti con lesione cerebrale destra affetti o non affetti da anosognosi
Fattori predittivi di durata della degenza in soggetti con trauma cranio-encefalico.
No full textNei pazienti affetti da gravi cerebrolesioni acquisite, le valutazioni cliniche e strumentali effettuabili in fase acuta non possono dare elementi di certezza circa i benefici che il singolo paziente può ricevere dal trattamento riabilitativo né su quali siano i percorsi di cura più appropriati; è però noto che la gravità della cerebrolesione ed il precoce ingresso in una struttura riabilitativa sia un fattore predittivo di outcome funzionale. Lo scopo di questo studio retrospettivo è stato quello di valutare, su un gruppo di pazienti affetti da trauma cranio-encefalico (TCE), quali fattori influivano sulla durata della degenza.
Abbiamo considerato tutti i pazienti al primo ricovero per TCE presso un’Unità di Riabilitazione Intensiva tra il 2004 e il 2006. Le variabili prese in esame in questo studio sono state la Glasgow Coma Scale (GCS) rilevata in fase acuta, il tempo intercorso tra il trauma e l’ingresso nel centro di Riabilitazione, la durata della degenza nella struttura riabilitativa e gli indicatori di outcome quali la Disability Rating Scale (DRS), la Levels of Cognitive Functions (LCF) misurati all’ingresso e alla dimissione.
Sono stati inclusi nello studio 138 soggetti (111 maschi e 27 femmine; età media 41.1 anni; SD 18.8) ammessi mediamente 36.8 giorni (SD 18.5) dopo il TCE.
All’analisi univariata risultava che la durata della degenza era significativamente correlata con la GCS iniziale (r= -519; p=0.000) e con i giorni trascorsi tra evento acuto e ingresso in riabilitazione (r= -687; p=0.0001). Alla dimissione il guadagno in termini di recupero della disabilità misurato alla DRS era significativamente correlata al numero di giorni di trattamento riabilitativo (r=0.433; p=0.0001), mentre le variazioni della LCF e della GOS non correlavano con la durata della degenza. In conclusione, dai nostri risultati emerge la possibilità di definire precocemente il percorso riabilitativo più appropriato nei soggetti con esiti di TCE
Overt and covert processing of left side information in unilateral neglect investigated with chimeric drawings
No full textOvert and covert processing of contralesional information was investigated in 6 right-brain-damaged (RBD) patients with or without left hemispatial neglect by using three bedside tests that require the analysis of whole, half, and chimeric drawings. In the first task, patients named these stimuli. In the second task, patients designated as "same" or "different" drawings in a pair where one drawing was always whole and the other could be whole, half, or chimeric. In the third task, patients pointed to the more veridical, complete drawing that was presented with one half drawing, and two chimeric drawings. Although patients with no neglect performed without error in all conditions, patients with severe neglect based their performance on the analysis of the right side of the stimuli. In patients with mild neglect, not only did performance rely upon the right side of stimuli but it was also modulated by left-side information acquired either overtly or unconsciously
Valutazione neuropsicologica iniziale nel trauma cranico con la batteria di test Luria Nebraska Neuropsychological Battery (LNNB)
No full textExploring variables associated with rehabilitation length of stay in brain injuries patients.
No full textBACKGROUND:
The impact of outcome measure as early variables on rehabilitation length of stay (LOS) in traumatic brain injury (TBI) patients remains poorly investigated.
AIM:
To investigate: 1) the association between LOS and motor and functional outcomes; 2) the predictive factors of LOS in TBI patients admitted to a rehabilitation center.
DESIGN:
Retrospective study.
SETTING:
Inpatient TBI Rehabilitation Centre.
POPULATIONS:
241 TBI patients (190 males and 51 females, mean age 43.61±19.4 years, initial Glasgow Coma Scale of 6.96±3.39).
METHODS:
We recorded demographic characteristics (age, sex, setting and LOS in the acute phase, rehabilitation LOS) and outcome measures (Glasgow Outcome Scale, Disability Rating Scale, Levels of Cognitive Functioning, Functional Independence Measure).
RESULTS:
Average rehabilitation LOS was 58.82±58 days; 191 (79%) subjects were discharged from the rehabilitation center within 90 days. Rehabilitation LOS was significantly correlated with acute-care LOS (P=0.001) and Glasgow Coma Scale, but not with patients' age (P=0.250) or sex (P= 0.348). Rehabilitation LOS was significantly correlated with functional and cognitive admission outcome scores but not with gains during rehabilitation. Rehabilitation LOS was significantly less in the group of patients that returned back home respect to others. Regression analysis also illustrated that longer acute-care LOS was independently associated with significantly increased rehabilitation LOS (P<0.001).
CONCLUSION:
Our retrospective study suggests that rehabilitation LOS in TBI patients is correlated with timing of and score at admission to the rehabilitation setting rather than with gains in functional outcome.
CLINICAL REHABILITATION IMPACT:
This result may help to optimize inpatient service utilization, especially in term of LOS
Predictive factors for arnbulation in stroke patients in the rehabilitation setting: A multivariate analysis
No full textAbstract
OBJECT:
The purpose of this study was to investigate predictive factors for ambulatory recovery in stroke patients undergoing rehabilitation.
METHODS:
One hundred and eight-five first-stroke hemiplegics, admitted to an inpatient stroke rehabilitation program, were consecutively recruited to the study. Functional status at admission and discharge was evaluated by the Functional Independence Measure (FIM) and its motor component (motFIM), the upper and lower Motricity Index (upMI and lowMI), and the Trunk Control Test (TCT). The outcome variable was the Functional Ambulation Classification (FAC) score, assessed at discharge from rehabilitation. Multivariate analysis was used to assess the relationships between functional outcome (FAC), and the predictive variables.
RESULTS:
Up- and lowMI, FIM and motFIM, TCT and age at admission were significantly related to ambulatory recovery at discharge. Logistic regression analysis showed that the independent variables related to FAC were age, TCT and FIM: the model correctly allocated 86 out of 100 cases in the construction set and 76% of cases in the validation set. The ROC curve with logistic function output as the risk factor afforded very good accuracy (ROC area=0.94), sensitivity=86.5% and specificity=85.4%.
CONCLUSIONS:
Our results show that age and level of motor and functional impairment measured at baseline are significant predictors of ambulatory outcome. These findings promise to be of interest in goal optimization in the rehabilitation setting
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