F-3-18-04
Relation between functional gains and initial functional scores in stroke rehabilitation Tokutaro Sato (Tohoku University, Sendai, Japan)
To clarify relation between functional scores on admission and functional gains by inpatient rehabilitation, mini mental state (MMS), manual functional score (MFS), motor age (MOA) and Barthel index (BI) were followed for 2 months in 234 stroke patients. The regression curve of functional scores and functional gains showed the peaked pattern in MMS, MFS, MOA and BI, and correlation coefficient between functional scores on admission and gains at 2 months were 0.412, 0.455, 0.348 and 0.687, respectively. In many cases, BI score was improved to full scale by rehabilitation therapy, and functional gains in patients with the initial score of zero was much higher in BI than other functions.
It is important to realize that much of the ceiling effect and less of the floor effect is present in gains of BI by stroke rehabilitation.
F-3-18-05
MOTOR EVOLUTION IN HEMIPLEGICS: a follow-up during more than 5 years
Lains J., Oliveira R., Padrao P., Lopes S., Guedes A., Keating J. (Coimbra University Hospital -Portugal)
The authors develop a prospective research with hemiplegics, victims of stroke, during the years 1990- 92.
The methodology used for motor evaluation is the Toulouse Hemiplegic Motor Scale (Ch. Roques), that has the items: bed autonomy / trunk balance, standing / walking, upper limb and spasticity.
The patients, until now, were evaluated at the 1st, 4th, 6th, 12th months and in a chronic status (5th - 7th years post-stroke).
In motor status we saw a positive and statistically significant evolution until the end of the 1st year. Since then, until the chronic situation, we found that the motor scale (total and in each item) showed a statistically significant worsening.
Those hemiplegics with a very good motor scale (score superior to 85%), on the contrary, revealed to mantain some positive motor evolution.
The few patients (only 5) that did some rehabilitation, since the 12th month until the chronic period (10 to 15 sessions once or twice each year) showed statistically significant differences in the items upper limb and spasticity, but not in the others items and in the total score.
Conclusion: chronic hemiplegics must mantain some rehabilitation except those with none or only very few motor impairments.
