Lower Functional Independence Measure Motor Research Articles

Pressure ulcers acquired during inpatient rehabilitation after spinal cord injury, characterization and predictors: A 15-years' experience.

Most studies focus on the risk factors associated with the development of pressure ulcers (PUs) during acute phase or community care for individuals with spinal cord injury (SCI). This study aimed to i) compare clinical and demographic characteristics of inpatients after SCI with PUs acquired during rehabilitation vs inpatients without PUs and ii) evaluate an existing PU risk assessment tool iii) identify first PU predictors. Individuals (n = 1,135) admitted between 2008 and 2022 to a rehabilitation institution within 60 days after SCI were included. Admission Functional Independence Measure (FIM), American Spinal Injury Association Impairment Scale (AIS) and mEntal state, Mobility, Incontinence, Nutrition, Activity (EMINA) were assessed. Kaplan-Meier curves and Cox proportional hazards models were fitted. Overall incidence of PUs was 8.9%. Of these, 40.6% occurred in the first 30 days, 47.5% were sacral, 66.3% were Stage II. Patients with PUs were older, mostly with traumatic injuries (67.3%), AIS A (54.5%), lower FIM motor (mFIM) score and mechanical ventilation. We identified specific mFIM items to increase EMINA specificity. Adjusted Cox model yielded sex (male), age at injury, AIS grade, mFIM and diabetes as PUs predictors (C-Index = 0.749). Inpatients can benefit from combined assessments (EMINA + mFIM) and clinical features scarcely addressed in previous studies to prevent PUs.

Evaluation of functional outcomes in traumatic spinal cord injury with rehabilitation-acquired urinary tract infections: A retrospective study

ObjectiveThe objective of this study was to evaluate the impact of urinary tract infections (UTIs) acquired during acute inpatient traumatic Spinal Cord Injury (tSCI) rehabilitation on Functional Independence Measure (FIM) gains.DesignRetrospective chart review of consecutive patients with tSCI admitted to an acute rehabilitation facility from 2007–2012. The primary outcome was FIM scores and the association with UTI.ResultsThe sample included 110 patients and 70 acquired UTIs. No demographic differences were observed between groups with and without UTI. Those with UTIs had significantly lower FIM motor scores, on admission, discharge, and gain, as well as lower FIM efficiency and longer lengths of stay compared to those without a UTI. Recurrence of UTI was associated with increased length of stay, but did not impact FIM motor gains.ConclusionsThere was a statistically significant correlation between acquired UTIs and lower FIM motor scores on admission, gain, and discharge in tSCI rehabilitation. The correlation of UTI and decreased FIM gains are similar to other neurorehabilitation populations with UTI occurrence. UTIs are an important negative variable when measuring functional outcomes in rehabilitation. Further prospective studies should be performed to investigate this correlation.

Abstract TP147: Factors Influencing Home Discharge Preference of Inpatients With Acute Cerebral Infarction: A Retrospective Cohort Study

Background and Purpose: Many previous studies explained clinical predictors of discharge planning for inpatients with acute cerebral infarction, while the factors that influence inpatients and their family’s preference for discharge destination are not often investigated. The purpose of this study was to clarify the relationship between home discharge preference of inpatients with acute cerebral infarction and socio-demographic factors or clinical characteristics. Methods: We surveyed the electronic medical records of 2,495 (mean age 73.5+ years, 62% were male) acute cerebral infarction patients who were admitted to a stroke center in Japan between January 1, 2011 and December 31, 2015. The main outcome variable was the home discharge preference within 5 days after hospitalization. The explanatory variables were socio-demographic and clinical factors. Multiple logistic regression analysis with backward variable selection was performed to investigate relationships between home discharge preference and these factors. Results: In all, 1,056 (42%) patients showed their preference for discharge to their homes. Multiple logistic regression analysis identified relationships between discharge preference to home and five variables. Patients exhibiting the following characteristics tend to show the preference for discharge to their home: higher age, paresis, cancer, cohabitating, and higher functional independence measure motor (FIM-M) score on admission (13-91 points). The odds ratio of these factors for home discharge preference were 1.02 per a year (95% confidence interval[95%CI] 1.00-1.03), 3.68 (vs. without paresis, 95%CI 1.83-7.38), 2.35 (vs without cancer, 95%CI 1.11-4.94), 3.04 (vs. living alone, 95%CI 2.03-4.56), 1.06 (vs lower FIM-M score, 95% 1.05-1.07), respectively. The model showed an area under the curve equal to 0.83 (95%CI 0.80-0.86). Conclusion: Patients’ preference for home discharge is influenced largely by physical impairments and support availability. Additionally, patients with comorbidity such as cancer tend to choose facility care rather than home care. These results showed that development of a family support system for elder patients in multimorbid situations facilitated their decision for home discharge.

Poster 118 Prolonged Treatment of Paroxysmal Sympathetic Hyperactivity Limits Functional Gains: A Case Report

PM&RVolume 7, Issue 9S p. S130-S130 Friday Poster Presentation Poster 118 Prolonged Treatment of Paroxysmal Sympathetic Hyperactivity Limits Functional Gains: A Case Report Tomasz Chec BS, Tomasz Chec BS Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United StatesSearch for more papers by this authorZiva Petrin MD, Ziva Petrin MD Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United StatesSearch for more papers by this authorMatthew B. Sonagere DO, Matthew B. Sonagere DO Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United StatesSearch for more papers by this authorKristofer J. Feeko DO, Kristofer J. Feeko DO Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United StatesSearch for more papers by this author Tomasz Chec BS, Tomasz Chec BS Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United StatesSearch for more papers by this authorZiva Petrin MD, Ziva Petrin MD Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United StatesSearch for more papers by this authorMatthew B. Sonagere DO, Matthew B. Sonagere DO Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United StatesSearch for more papers by this authorKristofer J. Feeko DO, Kristofer J. Feeko DO Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United StatesSearch for more papers by this author First published: 08 September 2015 https://doi.org/10.1016/j.pmrj.2015.06.157Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume7, Issue9SSeptember 2015Pages S130-S130 RelatedInformation

Poster 5: Cognitive Correlates With Functional Outcome After Anoxic Brain Injury: A Case-Controlled Comparison With Traumatic Brain Injury

Objectives: To assess the effectiveness of inpatient rehabilitation in adults who have sustained an anoxic brain injury (AnBI). Secondly, to identify areas of cognition that predict functional outcomes at discharge. Design: Retrospective, matched case-controlled study. Methods: Ten patients with moderate-to-severe AnBI and 10 patients with traumatic brain injury (TBI), treated in an inpatient neurorehabilitation programme, were matched on age, acute care length of stay and admission Functional Independence Measure (FIM). Functional outcome was assessed using the FIM and Disability Rating Scale (DRS). Results: Patients with AnBI performed worse on all measures of functional outcome relative to patients with TBI. Patients with AnBI achieved significantly lower FIM motor and cognitive gain compared with patients with TBI (11.5, SD 13.6 vs. 31.0, SD 19.7 and 2.4, SD 3.9 vs. 7.5, SD 4.2, respectively (p < 0.02)). DRS data showed similar trends of functional improvement between the groups. Several neuropsychometric tests correlated with functional outcome (p < 0.01). Conclusions: Patients with AnBI had worse functional outcomes following rehabilitation than patients with TBI, confirming the results of previous reports. Poor cognitive function predicted poor functional outcomes on the FIM and somewhat on the DRS. Research is needed to assess why these differences occur and to improve or develop new effective rehabilitation treatments for AnBI.