Evaluation of and controversies in stroke rehabilitation
| Autor: | Fletcher McDowell |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Rehabilitation nursing
education.field_of_study medicine.medical_specialty Rehabilitation business.industry medicine.medical_treatment Incidence (epidemiology) Population Stroke mortality medicine.disease Hemiparesis Ischemic cerebral infarction medicine Physical therapy Surgery Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine education business Stroke |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 2:61-63 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/s1052-3057(10)80039-4 |
| Popis: | The decline in stroke mortality, increased longevi ty, and modest increases in the incidence of stroke result in more individuals living with physical dis ability caused by cerebrovascular disease. This is creating an increasing burden on the facilities and expertise of individuals who are concerned with the rehabilitation of the patient after stroke. The costs of rehabilitation services are considerable, and there is concern about the cost-effectiveness of rehabilitative care for pat ients with stroke. Not every individual following a stroke is a candi date for rehabilitative therapy. A number of investi gations have been conducted as to who is most likely to benefit from stroke rehabilitation. Third-party reimbursers in the United States have made determi nations on this issue and have set guidehnes for ad missioncriteria for inpatient rehabihtation. Admission criteria include that the patient must (a) be medically stable, (b) be responsive to verbal or visual stimuli, (c) have sufficient mental alertness to participate in a program, and (d) have a condition that indicates a potential for rehabilitation with a reasonable expecta tion of improvement. The patient must be able to enter a program that requires at least 3 h of active participation per day in physical therapy, occupa tional therapy, speech therapy, or rehabilitation nursing. A number of attempts have been made to deter mine from the large population of patientswithstroke which ones might be the best candidates for rehabil itation. Assuming a population of 100 patients follow ing an ischemic cerebral infarction 14 days after the ons et of stroke, approximately 14% of the patients will be dead, 13% will be normal, 20% will have hemi plegia, 49% will have hemiparesis, and 4% will have monoparesis. Thus, 73% of the total are potential candidates for inpatient rehabilitation. Analyzing this group of 73 patients, approximately 18-24 will be too well to need inpatient rehabilitation and 18-24 will be too neurologically impaired or medically unstable to be able to enter a rehabilitation program, leaving approximately one-quarter to one-third of the total group as good candidates for rehabilitation. |
| Databáze: | OpenAIRE |
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