リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。

リケラボ 全国の大学リポジトリにある学位論文・教授論文を一括検索するならリケラボ論文検索大学・研究所にある論文を検索できる

リケラボ 全国の大学リポジトリにある学位論文・教授論文を一括検索するならリケラボ論文検索大学・研究所にある論文を検索できる

大学・研究所にある論文を検索できる 「Association between National Institutes of Health Stroke Scale and Functional Independence Measure scores in patients with ischemic stroke from convalescent rehabilitation outcomes」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。

コピーが完了しました

URLをコピーしました

論文の公開元へ論文の公開元へ
書き出し

Association between National Institutes of Health Stroke Scale and Functional Independence Measure scores in patients with ischemic stroke from convalescent rehabilitation outcomes

Senda, Joe Ito, Keiichi Kotake, Tomomitsu Mizuno, Masanori Kishimoto, Hideo Yasui, Keizo Nakagawa-Senda, Hiroko Katsuno, Masahisa Nishida, Yoshihiro 名古屋大学

2023.08

概要

In the post-acute stroke period, functional independence measures (FIMs)1 are used to assess
the patient’s degree of functional independence in performing activities of daily living (ADLs),
according to a 2016 mandate by the Japanese National Insurance System. However, the National
Institutes of Health Stroke Scale (NIHSS) is also a well-validated instrument to assess the
level of impaired neurological functions secondary to stroke.2 While FIM measures the level of
required physical and occupational assistance, which is non-specific to the neurological severities,
the NIHSS instrument measures impairment rather than disability. Therefore, the discrepancies
between the NIHSS and FIM become significant clinical issues upon use in the convalescent
rehabilitation stages.3
We can precisely diagnose ischemic stroke, particularly in the acute stages, using magnetic
resonance imaging (MRI) and magnetic resonance angiography (MRA). These imaging sequences
have enabled more suitable therapies for each ischemic stroke subtype. Moreover, leukoaraiosis
can be detected and assessed by MRI and is revealed as white matter hyperintensities to affect both cognitive and motor functions.4 Furthermore, the relationship between convalescent
rehabilitation outcomes and leukoaraiosis in post-ischemic stroke patients has been established.5
This study investigated the examinations that influence the discrepancies between the neurological severities and ADLs in patients with post-ischemic stroke regarding convalescent rehabilitation
outcomes. Therefore, we investigated the associations between NIHSS and FIM scores with
radiological diagnoses such as leukoaraiosis and arteriosclerosis using MRI, MRA, and various
other clinical factors. ...

この論文で使われている画像

参考文献

1 Granger CV, Cotter AC, Hamilton BB, Fiedler RC. Functional assessment scales: a study of persons after

stroke. Arch Phys Med Rehabil. 1993;74(2):133–138.

2 Goldstein LB, Samsa GP. Reliability of the National Institutes of Health Stroke Scale. Extension to nonneurologists in the context of a clinical trial. Stroke. 1997;28(2):307–310. doi:10.1161/01.STR.28.2.307.

3 Roth EJ, Heinemann AW, Lovell LL, Harvey RL, McGuire JR, Diaz S. Impairment and disability: their

relation during stroke rehabilitation. Arch Phys Med Rehabil. 1998;79(3):329–335. doi:10.1016/S00039993(98)90015-6.

4 Pantoni L, Poggesi A, Basile AM, et al. Leukoaraiosis predicts hidden global functioning impairment in

nondisabled older people: the LADIS (Leukoaraiosis and Disability in the Elderly) Study. J Am Geriatr

Soc. 2006;54(7):1095–1101. doi:10.1111/j.1532-5415.2006.00798.x.

5 Senda J, Ito K, Kotake T, et al. Association of Leukoaraiosis With Convalescent Rehabilitation Outcome

in Patients With Ischemic Stroke. Stroke. 2016;47(1):160–166. doi:10.1161/STROKEAHA.115.010682.

6 Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–65.

7 van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the

assessment of handicap in stroke patients. Stroke. 1988;19(5):604–607. doi:10.1161/01.STR.19.5.604.

8 Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in

Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987;149(2):351–356. doi:10.2214/

ajr.149.2.351.

9 Fazekas F, Kleinert R, Offenbacher H, et al. The morphologic correlate of incidental punctate white matter

hyperintensities on MR images. AJNR Am J Neuroradiol. 1991;12(5):915–921.

10 Henninger N, Khan MA, Zhang J, Moonis M, Goddeau RP Jr. Leukoaraiosis predicts cortical infarct volume after distal middle cerebral artery occlusion. Stroke. 2014;45(3):689–695. doi:10.1161/

STROKEAHA.113.002855.

11 Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular disease III. Stroke. 1990;21(4):637–676. doi:10.1161/01.STR.21.4.637.

12 Adams HP Jr, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke.

1993;24(1):35–41. doi:10.1161/01.STR.24.1.35.

13 Arsava EM, Rahman R, Rosand J, et al. Severity of leukoaraiosis correlates with clinical outcome after

ischemic stroke. Neurology. 2009;72(16):1403–1410. doi:10.1212/WNL.0b013e3181a18823.

14 Fazekas F, Kleinert R, Offenbacher H, et al. Pathologic correlates of incidental MRI white matter signal

hyperintensities. Neurology. 1993;43(9):1683–1689. doi:10.1212/WNL.43.9.1683.

15 Longstreth WT Jr, Dulberg C, Manolio TA, et al. Incidence, manifestations, and predictors of brain infarcts

defined by serial cranial magnetic resonance imaging in the elderly: the Cardiovascular Health Study. Stroke.

2002;33(10):2376–2382. doi:10.1161/01.STR.0000032241.58727.49.

16 Whitman GT, Tang Y, Lin A, Baloh RW. A prospective study of cerebral white matter abnormalities in

older people with gait dysfunction. Neurology. 2001;57(6):990–994. doi:10.1212/WNL.57.6.990.

17 Baezner H, Blahak C, Poggesi A, et al. Association of gait and balance disorders with age-related white

matter changes: the LADIS study. Neurology. 2008;70(12):935–942. doi:10.1212/01.WNL.0000305959.46197.

E6.

18 Fink JN, Selim MH, Kumar S, et al. Is the association of National Institutes of Health Stroke Scale

scores and acute magnetic resonance imaging stroke volume Stroke Scale scores and acute magnetic

resonance imaging stroke volume equal for patients with right- and left-hemisphere ischemic stroke? Stroke.

2002;33(4):954–958. doi:10.1161/01.STR.0000013069.24300.1D.

19 Woo D, Broderick JP, Kothari RU, et al. Does the National Institutes of Health Stroke Scale favor left

hemisphere strokes? Stroke. 1999;30(11):2355–2359. doi:10.1161/01.STR.30.11.2355.

20 Rexroth P, Fisher AG, Merritt BK, Gliner J. ADL differences in individuals with unilateral hemispheric

stroke. Can J Occup Ther. 2005;72(4):212–221. doi:10.1177/000841740507200403.

21 Caplan LR, Wong KS, Gao S, Hennerici MG. Is hypoperfusion an important cause of strokes? If so, how?

Cerebrovasc Dis. 2006;21(3):145–153. doi:10.1159/000090791.

22 Beloosesky Y, Streifler JY, Burstin A, Grinblat J. The importance of brain infarct size and location in

predicting outcome after stroke. Age Ageing. 1995;24(6):515–518. doi:10.1093/ageing/24.6.515.

23 Glymour MM, Berkman LF, Ertel KA, Fay ME, Glass TA, Furie KL. Lesion characteristics, NIH stroke

scale, and functional recovery after stroke. Am J Phys Med Rehabil. 2007;86(9):725–733. doi:10.1097/

PHM.0b013e31813e0a32.

Nagoya J. Med. Sci. 85. 428–443, 2023

441

doi:10.18999/nagjms.85.3.428

Joe Senda et al

24 d’Orsi E, Xavier AJ, Steptoe A, et al. Socioeconomic and lifestyle factors related to instrumental activity

of daily living dynamics: results from the English Longitudinal Study of Ageing. J Am Geriatr Soc.

2014;62(9):1630–1639. doi:10.1111/jgs.12990.

25 Hozawa A, Okamura T, Murakami Y, et al. High blood pressure in middle age is associated with a future

decline in activities of daily living. NIPPON DATA80. J Hum Hypertens. 2009;23(8):546–552. doi:10.1038/

jhh.2008.155.

26 Bagg S, Pombo AP, Hopman W. Effect of age on functional outcomes after stroke rehabilitation. Stroke.

2002;33(1):179–185. doi:10.1161/hs0102.101224.

27 Craig LE, Wu O, Bernhardt J, Langhorne P. Predictors of poststroke mobility: systematic review. Int J

Stroke. 2011;6(4):321–327. doi:10.1111/j.1747-4949.2011.00621.x.

28 Stineman MG, Granger CV. Outcome, efficiency, and time-trend pattern analyses for stroke rehabilitation.

Am J Phys Med Rehabil. 1998;77(3):193–201. doi:10.1097/00002060-199805000-00003.

29 Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief

screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–699. doi:10.1111/j.15325415.2005.53221.x.

30 Matsushita T, Nishioka S, Taguchi S, et al. Effect of Improvement in Sarcopenia on Functional and

Discharge Outcomes in Stroke Rehabilitation Patients. Nutrients. 2021;13(7):2192. doi:10.3390/nu13072192.

31 Ogawa T, Suenaga M. Elderly Patients after Stroke Increase Skeletal Muscle Mass by Exercise Therapy

in Rehabilitation Wards. J Stroke Cerebrovasc Dis. 2021;30(9):105958. doi:10.1016/j.jstrokecerebrovasdis.

2021.105958.

32 Kishimoto H, Yozu A, Kohno Y, Oose H. Nutritional improvement is associated with better functional

outcome in stroke rehabilitation: A cross-sectional study using controlling nutritional status. J Rehabil Med.

2020;52(3):jrm00029. doi:10.2340/16501977-2655.

33 Lipson-Smith R, Pflaumer L, Elf M, et al. Built environments for inpatient stroke rehabilitation services

and care: a systematic literature review. BMJ Open. 2021;11(8):e050247. doi:10.1136/bmjopen-2021-050247.

34 Baseman S, Fisher K, Ward L, Bhattacharya A. The relationship of physical function to social integration

after stroke. J Neurosci Nurs. 2010;42(5):237–244. doi:10.1097/JNN.0b013e3181ecafea.

Nagoya J. Med. Sci. 85. 428–443, 2023

442

doi:10.18999/nagjms.85.3.428

NIHSS and FIM after ischemic stroke

SUPPLEMENTAL TABLES

Multiple linear regression analysis of associations between NIHSS and total FIM with clinical factors

according to the classifications of total FIM score

(a) FIM scores from 18 to 55, n=84 (Male=46, Female=38, Age 79.1±8.7)

Pearson correlation coefficient: r= –0.427, P value <0.001

P value

NIHSS score at discharge

–0.460

–0.718

<0.001

PVH grade

–0.238

–2.441

0.017

Influencing factors

R2

0.238

(b) FIM scores from 56 to 99, n=257 (Male=152, Female=105, Age 76.4±9.4)

Pearson correlation coefficient: r= –0.324, P value <0.001

Influencing factors

P value

NIHSS score at discharge

–0.420

–1.079

<0.001

Age

–0.386

–0.517

<0.001

Hypertension

–0.112

–2.814

0.048

R2

0.249

(c) FIM scores from 100 to 126, n=382 (Male=247, Female=135, Age 70.0±11.1)

Pearson correlation coefficient: r=–0.371, P value <0.001

P value

NIHSS score at discharge

–0.418

–1.047

<0.001

Age

–0.253

–0.158

<0.001

PVH grade

–0.178

–1.352

<0.001

History of heart disease positive

–0.105

–2.889

0.032

Influencing factors

R2

0.278

FIM: Functional Independence Measure

NIHSS: National Institutes of Health Stroke Scale

PVH: periventricular hyperintensity

b: standardized regression coefficient

B: unstandardized coefficient

R2: coefficient of determination

References End

Nagoya J. Med. Sci. 85. 428–443, 2023

443

doi:10.18999/nagjms.85.3.428

...

参考文献をもっと見る

全国の大学の
卒論・修論・学位論文

一発検索!

この論文の関連論文を見る