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- Martinsson, L, et al.
(författare)
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Activity Index - a complementary ADL scale to the Barthel Index in the acute stage in patients with severe stroke
- 2006
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Ingår i: Cerebrovascular diseases (Basel, Switzerland). - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 22:4, s. 231-239
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Tidskriftsartikel (refereegranskat)abstract
- <i>Objective:</i> It was the aim of this study to compare the Barthel Index (BI) and the activities of daily living (ADL) component of the Activity Index [AI(ADL)] regarding floor and ceiling effects, responsiveness and the predictive value for survival during the first week until 3 months after stroke onset. <i>Patients and Methods:</i> Basic ADL were assessed in 75 patients with ischaemic stroke. <i>Results:</i> There was a strong concordance between BI and AI(ADL) scores at all time points (Kendall’s τ<sub>b</sub> = 0.7878, p < 0.0001 at baseline; Kendall’s τ<sub>b</sub> = 0.8901, p < 0.0001 at 1 week; Kendall’s τ<sub>b</sub> = 0.9027, p < 0.0001 at 3 months). BI had a significantly more pronounced floor effect at baseline and at 1 week compared with AI(ADL) in patients with severe stroke. Both scales had a substantial ceiling effect at 3 months. At 1 week, the baseline BI score was significantly higher in patients being alive as compared with those who had died, while their AI(ADL) score did not differ significantly. At 3 months, baseline BI and AI(ADL) scores were significantly higher in patients being alive as compared with those who had died. The predictive value of being alive at 1 week and 3 months did not differ between BI and AI(ADL). <i>Conclusion:</i> AI(ADL) is recommended to be used in addition as a complement to BI in patients with severe stroke since the floor effect with BI in the acute stage is significantly more pronounced than with AI(ADL), thus hampering the responsiveness.
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- Martinsson, L, et al.
(författare)
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Intensive early physiotherapy combined with dexamphetamine treatment in severe stroke: a randomized, controlled pilot study
- 2003
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Ingår i: Cerebrovascular diseases (Basel, Switzerland). - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 16:4, s. 338-345
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> The most severely disabled stroke patients are often excluded from studies evaluating effects of physiotherapy. This study intended to investigate the effect of an increased intensity of physiotherapy in combination with dexamphetamine the first week after ischemic stroke in patients with an impaired level of consciousness and severe motor dysfunction. <i>Methods:</i> Thirty patients were enrolled within 96 h after onset of symptoms. Patients were randomized to 30–45 min of physiotherapy twice daily or to maximally 15 min per day for 5 days. All patients received dexamphetamine to achieve alertness. Functional outcome measures were assessed at baseline, the day after treatment discontinuation, and 3 and 12 months after stroke onset. Residence of living was registered at long-term follow-ups. <i>Results:</i> No statistically significant differences were seen between groups in the outcomes measured at any time point. However, both groups improved over time in all outcomes at 3 and 12 months (p < 0.05), except for sensory functions at 3 months and motor functions at 12 months. The number of patients needed to treat (NNT) to achieve the desired improvement in Lindmark motor score was 8, with the 95% CI being NNT(harm) 10 to NNT(beneficial) 3. The fraction of patients who died was the same in both treatment groups, 47% (95% CI 28–65%). <i>Conclusions:</i> An increased intensity of physiotherapy in combination with dexamphetamine during the first week after stroke onset did not affect short- or long-term outcome in this limited sample of patients with severe stroke.
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