Investigation of Inpatient Rehabilitation Outcomes in different Ischemic Stroke Disease Types : Relationships with Leukoaraiosis in MRI

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  • SENDA Joe
    Aisei-kai Kami-iida Rehabilitation Hospital Department of Neurology, Nagoya University Graduate School of Medicine
  • ITO Keiichi
    Aisei-kai Kami-iida Rehabilitation Hospital
  • HAMADA Kensuke
    Aisei-kai Kami-iida Rehabilitation Hospital
  • KOTAKE Tomomitsu
    Aisei-kai Kami-iida Rehabilitation Hospital
  • KISHIMOTO Hideo
    Aisei-kai Kami-iida Rehabilitation Hospital
  • SOBUE Gen
    Department of Neurology, Nagoya University Graduate School of Medicine

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Other Title
  • 脳梗塞病型別にみた回復期リハビリテーション成績の検討　　―ＭＲＩ脳白質病変との関係―
  • ノウコウソクビョウ カタベツ ニ ミタ カイフクキ リハビリテーション セイセキ ノ ケントウ MRI ノウ ハクシツ ビョウヘン ト ノ カンケイ
  • —MRI脳白質病変との関係—

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Abstract

Purpose : The aim of this study is to investigate inpatient rehabilitation outcomes in different ischemic stroke disease types. Subjects and methods : Subjects were 178 patients with ischemic stroke transferred from stroke units or emergency units for inpatient rehabilitation at Kami-iida Rehabilitation Hospital. For all patients, National Institutes of Health Stroke Scale (NIHSS) scores were measured on admission. Functional Independence Measure (FIM) scores were also measured both on admission and discharge, and FIM-gain (FIM-g) and FIM-efficiency (FIM-e) values were calculated. The disease types of ischemic stroke were : lacunar (LI) in 16 patients ; atherothrombosis (AI) in 23 ; branch-atheromatous-disease (BAD) in 59 ; artery to artery embolism (A to A) in 18; cardiogenic embolism (CE) in 34 ; undetermined embolism (unable to differentiate from A to A and cardiogenic embolism) in 22 ; the 6 remaining patients were not categorized. Results : There were no significant differences in the NIHSS scores and FIM scores on admission between disease types except for the NIHSS scores in the LI patients. The FIM-e value in A to A patients was significantly lower than those in other types (p<0.05). Moreover, A to A patients have a tendency of severe leukoaraiosis and their MRAs demonstrated high rates of stenosis (≥50%) or occlusion with intracranial arteries. Conclusion : In A to A embolism, significantly lower FIM-e values were found and FIMs at discharge were affected by leukoaraiosis on the basis of large-vessel arteriosclerosis. Our study revealed that inpatient rehabilitation outcomes differed for each ischemic stroke type and appeared to be influenced by leukoaraiosis.

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