Association between the functional independence measure and Glasgow coma scale regarding the rehabilitation outcomes of traumatic brain injury

To evaluate the outcomes of early comprehensive rehabilitation protocols for traumatic brain injury [TBI] using the functional independence measure [FIM], and to study the relationship between FIM and Glasgow coma scale [GCS] variables to determine which patients will be best served by rehabilitation therapies. Fifty-one subjects with diagnosed TBI receiving treatment at a single inpatient rehabilitation facility at Jordan University of Science and Technology, Teaching Hospital, Irbid, Jordan were enrolled in this experimental study between August 2006 and February 2008. Of the enrolled subjects, 47 completed the study. The mean age of the participants was 33 years [8 females and 39 males]. Glasgow coma scale was measured on admission. Functional independence measure score was measured on admission and on discharge. According to the GCS, the participants were divided into 3 groups as severe injury [GCS: 3-8 [n = 24]], moderate injury [GCS: 9-12 [n = 12]], and mild or no injury [GCS: 13-15 [n = 11]]. The FIM score and CGS and their relation were evaluated. Evaluation outcomes revealed a significant improvement in FIM scores after rehabilitation compared to the FIM admission [p = 0.00006] in severe TBI. In moderate TBI, the FIM scores were significantly improved [p = 0.0004] after rehabilitation. However, with minimal injury, the FIM scores were not significantly improved [p = 0.15]. Early rehabilitation interventions significantly improved the FIM scores in moderate and severe TBI patients

Effect of risk factors on functional outcome after stroke rehabilitation

The incidence of stroke and the demand for rehabilitation services continues to increase. Risk factors may act as stroke outcome predictors and hence determine the type and intensity of rehabilitation. Our aim is to investigate stroke outcome predictors that will define groups with maximal or minimal benefit from rehabilitation after stroke. Our longitudinal prospective study included 111 ischemic stroke patients, admitted consecutively to the Rehabilitation Department, Hamad Medical Corporation, Qatar, during 2000-2001. We analyzed the influence of modifiable risk factors: diabetes mellitus [DM], hypertension [HTN], ischemic heart disease [IHD] and non-modifiable factors: age, gender, race and side of lesion on stroke outcome. All patients received regular rehabilitation and underwent an evaluation on admission and discharge, using the Modified Barthel Index. Statistical analysis demonstrated that the group of patients with IHD showed greatest improvement after 3 months of rehabilitation. The group without co-morbidities followed this, and then the HTN, DM, combined DM and HTN and combined HTN and IHD groups. The group that suffered from combined DM, HTN, and IHD did not show improvement. Non-modifiable risk factors showed no significant differences. However, younger patients showed a tendency for better improvement. Those patients with modifiable risk factors had significant impact on rehabilitation outcome [p-value = 0.009]. Those with one or 2 co-morbidities had the highest score of improvement after rehabilitation while the group of patients with more than 2 co-morbidities did not show improvement. However, non-modifiable risk factors did not play a significant role in stroke outcome