P-2-04-13
COGNITIVE FUNCTION AND ACTIVITIES OF DAILY LIVING IN ELDERLY STROKE PATIENTS
Shinichiro Maeshima (Rehabilitation Studies, University of Sydney & Royal Rehabilitation Centre, Sydney, Australia), Stephen F. Wilson (Greenwich Hospital), Wesley Baker (Royal North Shore Hospital), Ian Cameron (Hornsby Hospital), Stephen Bucldey (Mr. Wilga Private Hospital)
The aim of this study is to investigate the relationship between cognitive function and activities of daily living in elderly stroke patients.
Fifty-eight patients, aged 65 years or older with unilateral stroke, were measured using the Mini-mental state examination (MMSE, Folstein 1974) and functional independence measure (FIM) on admission, discharge, and six month after discharge.
Cognitive impairment was present in 27 cases (46.6%) on admission. Patients with cognitive impairment on admission had lower FIM scores in self-care, sphincter control, communication and social cognition on admission, lower FIM scores in all subscales on discharge, and lower FIM scores in communication and social cognition on follow up than patients without cognitive impairment. There was no significant difference between cognitive impairment on admission and age, gender, duration from the onset, lesion side and length of stay.
These results suggest that cognitive impairments affects to the ADL and MMSE might be useful indicator for predicting the functional outcome in elderly stroke patients.
P-2-05-01
DEVELOPMENT OF A TESTING PROCEDURE FOR SWALLOWING DISORDERS IN PATIENTS WITH STROKE
Yukio Noda, Aritoshi Shirasaka, Sabro Shimao, Yasunofi Kojima (Shizuoka Rehabilitation Hospital, Shizuoka, Japan)
Dysphagia is a common problem for stroke patients, especially for patients having aspiration pneumonia. The Videofluoroscopic studies revealed that the aspiration frequently occurred in the pharyngeal stage and the main cause of aspiration was a delay in swallowing reflex. We developed a new technique to elucidate the slowing of the laryngel elevation during deglutition in stroke patients.
We attached a piezoelectric gaze in front of the neck, just above the thyroid cartilage, to record laryngeal movement. A sensor was connected to an EMG machine and we measured the time intervals from the starting signal to laryngeal elevation, while the subject was swallowing 1 ml of water. Stroke patients with dysphagia showed significantly prolonged laryngeal elevation. Non-dysphagic stroke patients revealed no significant delay compared to the control group. This test might be a simple but useful examination to analyze the swallowing disorders in patient with stroke.
