ABSTRACT
This study sought to elucidate the relationship between units of rehabilitative training time and Functional Independence Measure (FIM) at time of discharge in femoral neck fracture patients. The subjects were 795 patients with femoral neck fracture from 19 hospitals registered in the Japan Rehabilitation Database who satisfied the inclusion criteria. Separating these into 15 hospitals (371 cases) where surgery was performed at outside institutions and 14 hospitals (424 cases) where surgery was performed in-house, multiple regression analysis was performed using six explanatory variables including hospital dummy and training time units, and motor FIM score at discharge as an objective variable. In the outside surgery group, whose training time units ranged from 0.8 to 8.6, the coefficient was not significant. However, it became significant when narrowed to two hospitals comprising more than 50 cases (<i>B</i>=2.187). The in-house surgery group's training time units represented a significantly positive coefficient (1.427). It is thought that if the number of training time units used for patients with femoral neck fractures increases by one unit, then the patient's motor FIM score at discharge will rise about 1.4 to 2 points.
ABSTRACT
After April 2006, the Japanese Ministry of Health and Labor raised the permitted training time from 6 to 9 units (1 unit of training time corresponds to 20 minutes of exercise with a therapist) for patients in a kaifukuki (convalescent) rehabilitation ward. We examined the effect of the increased rehabilitative training time on patients using feeding tubes in a kaifukuki rehabilitation ward after an initial cerebrovascular disorder, with a particular focus on improving swallowing disorders. Our study was comprised of post-stroke patients with feeding tubes who underwent rehabilitation from April 2001 to March 2006 (<i>N</i>=14, 6-unit group) and from April 2006 to March 2009 (<i>N</i>=16, 9-unit group). All patients went to the ward within two months after suffering a stroke. There was no significant difference in the Functional Independence Measure(FIM) efficiency or length of hospital stay between the two groups. Feeding tube removal was more common in the 9-unit group compared to the 6-unit group (81.3% vs. 35.7%, <i>p</i><0.05), and the 9-unit group also had more training time per day. Logistic regression analysis showed that the increased training time per day spent with a speech therapist contributed to improving swallowing disorders (<i>p</i><0.01).
ABSTRACT
OBJECTIVE: To evaluate the varying effects of rehabilitation intensity classified by the number of treatment sessions on recovery of activity and function in stroke subjects. METHOD: Eighty nine subjects with stroke (51 infarction, 38 hemorrhage) had received conventional rehabilitation programs (physical therapies, occupational therapies) with 30 minutes per each therapy. They were divided into two groups; group I consisted of 42 subjects who received one session of rehabilitation therapy per day; group II consisted of 47 subjects received two sessions per day. Functional outcomes, such as K-BBS (Korean version of Berg Balance Scale), FIM (Functional Independence Measure), and MMSE-K (Korean version of Mini Mental State Examination) were assessed with two weeks interval. Data was analyzed the differences of functional outcomes assessed at the initial time of treatments (the initial) and at the time of the peak K-BBS (the second). RESULTS: Age, sex, lesion sites, the initial K-BBS, the initial FIM, and MMSE-K scores had no differences between two groups (p>0.05). There were significant differences between the initial and the second K-BBS, and the initial FIM and the second FIM in group I & II, respectively (p0.05). Also, length of stay was no significant differences between two groups. CONCLUSION: The above findings suggest that though all rehabilitation programs affect the functional improvement of stroke subjects, the daily rehabilitation training time could be more important factor for functional improvement in subjects with stroke, especially on recovery of ambulation rather than the sum of functional gain.
ABSTRACT
We examined the effect of increased rehabilitative training time on patients with cerebrovascular disorders at a convalescent rehabilitation ward in Japan. After April 2006, the Japanese Ministry of Health and Labor raised the permitted training time from 6 to 9 units (1 unit of training time corresponds to 20 minutes of exercise with a therapist) for patients in a convalescent rehabilitation ward. We compared patients who underwent rehabilitation during the period from April 2006 to March 2008 (9-unit group, 131 patients) with those rehabilitated from April 2003 to March 2006 6-unit group, 153 patients) in the convalescent rehabilitation ward of our hospital. The patients were evaluated with FIM instruments at admission and discharge. Length of hospital stay and rate of return to the patient's home were also examined. The 9-unit group had a shorter hospital stay, and higher FIM efficiency scores, and also a higher rate of home return compared with the 6-unit group.