Executive functioning as a predictor of stroke rehabilitation outcomes.
Executive functioning as a predictor of stroke rehabilitation outcomes.
复制标题
执行功能作为中风康复结果的预测因子。
DOI：
10.1080/13854046.2018.1546905
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Grigsby,Jim
中科院分区：
文献类型：
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作者：
Shea-Shumsky,NBeckett;Schoeneberger,Stefanie;Grigsby,Jim
目的：卒中是成人慢性神经功能障碍和死亡的常见原因。虽然心血管疾病等因素会影响中风的发病率，但人们对影响纵向中风预后的因素知之甚少。本研究的目的是评估出院时的执行功能(EF)对卒中康复单元出院到12个 月之间的几个时间点的功能状态的预测作用，并与抑郁、精神状态、出院时的疼痛和入院前的日常功能进行比较。患者(或代理人)在出院时亲自采访他们从事日常生活活动的能力，并在出院后3、6、9和12 月通过电话进行随访。功能结果包括洗澡、穿衣、走路、使用厕所和转椅/床的独立性。结果：执行功能、抑郁和入院前的ADL功能是所有五个时间点的强预测因子，而在任何回归模型中都没有保留任何共病或精神状态。出院时疼痛是出院时和6个 月随访的显著预测因素。结论：执行功能和抑郁是中风康复后功能状态的有力预测因素。尽管疼痛并不总是一个重要的预测因素，但它也可能是预测模型的有用补充。
Objective:Stroke is a common cause of death and adult chronic neurologic disability. Although factors such as cardiovascular disease affect the incidence of stroke, less is known about factors influencing longitudinal stroke outcomes. The purpose of this research was to assess the contribution of executive functioning (EF) at discharge to the prediction of functional status at several timepoints between discharge from a stroke rehabilitation unit and 12 months, in comparison with depression, mental status, comorbidity, and pain at discharge, and daily functioning prior to admission.Methods:The sample comprised 246 inpatients aged 65 and older who were on inpatient rehabilitation services following acute hospitalization for a stroke. Patients (or proxies) were interviewed in person at discharge about their ability to engage in activities of daily living (ADL), and by telephone at follow-ups 3, 6, 9, and 12 months after discharge. Functional outcomes included independence in bathing, dressing, walking, use of the toilet, and chair/bed transfers. Hypotheses were tested concerning the relative contribution of EF, depression, mental status, comorbidity, and several other demographic and clinical variables to ADL performance.Results:Executive functioning, depression, and pre-admission ADL functioning were strong predictors of outcome at all five timepoints, while neither comorbidity nor mental status were retained in any regression models. Pain at discharge was a significant predictor at discharge and 6 month follow-up.Conclusions:Executive functioning and depression are robust predictors of functional status following stroke rehabilitation. Although not consistently a significant predictor, pain might also be a useful addition to predictive models.