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Koyama T, Mochizuki M, Uchiyama Y, Domen K. Outcome Prediction by Combining Corticospinal Tract Lesion Load with Diffusion-tensor Fractional Anisotropy in Patients after Hemorrhagic Stroke. Prog Rehabil Med 2024; 9:20240001. [PMID: 38223334 PMCID: PMC10782178 DOI: 10.2490/prm.20240001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024] Open
Abstract
Objectives The objective of this study was to evaluate the predictive precision of combining the corticospinal tract lesion load (CST-LL) with the diffusion-tensor fractional anisotropy of the corticospinal tract (CST-FA) in the lesioned hemispheres regarding motor outcomes. Methods Patients with putaminal and/or thalamic hemorrhage who had undergone computed tomography (CT) soon after onset in our hospital were retrospectively enrolled. The CST-LL was calculated after registration of the CT images to a standard brain. Diffusion-tensor imaging was performed during the second week after onset. Standardized automated tractography was employed to calculate the CST-FA. Outcomes were assessed at discharge from our affiliated rehabilitation facility using total scores of the motor component of the Stroke Impairment Assessment Set (SIAS-motor total; null to full, 0 to 25). Multivariate regression analysis was performed with CST-LL and CST-FA as explanatory variables and SIAS-motor total as a target value. Results Twenty-five patients participated in this study. SIAS-motor total ranged from 0 to 25 (median, 17). CST-LL ranged from 0.298 to 7.595 (median, 2.522) mL, and the lesion-side CST-FA ranged from 0.211 to 0.530 (median, 0.409). Analysis revealed that both explanatory variables were detected as statistically significant contributory factors. The estimated t values indicated that the contributions of these two variables were almost equal. The obtained regression model accounted for 63.9% of the variability of the target value. Conclusions Incorporation of the CST-LL with the lesion-side CST-FA enhances the precision of the stroke outcome prediction model.
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Affiliation(s)
- Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital, Nishinomiya, Japan
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Nishinomiya, Japan
| | - Midori Mochizuki
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital, Nishinomiya, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Nishinomiya, Japan
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Iwasa S, Uchiyama Y, Tauchi Y, Koyama T, Domen K. Impact of functional independence and sociodemographic factors on post-stroke discharge destination in a super-aged rural community in Japan. J Rural Med 2024; 19:33-39. [PMID: 38196805 PMCID: PMC10774001 DOI: 10.2185/jrm.2023-033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/23/2023] [Indexed: 01/11/2024] Open
Abstract
Objective: This study aimed to clarify the factors influencing the discharge destination of stroke patients in a super-aged rural community in Japan, focusing on functional independence and sociodemographic factors. Patients and Methods: We enrolled patients recovering from stroke with supratentorial lesions who were admitted to our convalescent rehabilitation hospital. The motor components of the Functional Independence Measure (FIM-motor) were assessed for each patient at admission and discharge as explanatory variables. An increase in the FIM-motor scores during hospitalization was also recorded. Additionally, sociodemographic data such as sex, age, and clinical characteristics, such as type of stroke, history of stroke, days from stroke onset to transfer to our convalescent rehabilitation hospital, total duration of hospital stay including acute care, number of co-resident household members, living with a spouse, and number of children were collected. As target values, discharge outcomes were categorized into two groups: returning home and going to a nursing home. Logistic regression analysis was performed. Results: The study sample comprised 160 patients (mean age ± standard deviation, 74.80 ± 12.19 years). Of these, 114 were discharged to their homes, and 46 were transferred to nursing homes. The results of multivariate logistic regression analysis indicated that higher FIM-motor scores at discharge, greater number of co-resident household members, and living with one's spouse were the most powerful predictors of a higher probability of returning home. Conclusion: This study demonstrated that functional independence levels and the number of co-resident household members were crucial factors in predicting the discharge destination of patients after stroke in a super-aged rural community in Japan. These findings imply that for older patients with lower functional independence, supportive social networks are essential for home discharge, offering clues for providing long-term healthcare in super-aged rural communities worldwide.
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Affiliation(s)
- Saya Iwasa
- Department of Rehabilitation Medicine, Sasayama Medical Center, Hyogo Medical University, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical University, Japan
| | - Yuta Tauchi
- Department of Rehabilitation Medicine, Sasayama Medical Center, Hyogo Medical University, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo Medical University, Japan
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical University, Japan
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Koyama T, Mochizuki M, Uchiyama Y, Domen K. Applicability of fractional anisotropy from standardized automated tractography for outcome prediction of patients after stroke. J Phys Ther Sci 2023; 35:838-844. [PMID: 38075519 PMCID: PMC10698312 DOI: 10.1589/jpts.35.838] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/14/2023] [Indexed: 03/22/2024] Open
Abstract
[Purpose] Diffusion-tensor fractional anisotropy has been used for outcome prediction in stroke patients. We assessed the clinical applicability of the two major fractional anisotropy methodologies-fractional anisotropy derived from segmentation maps in the standard brain (region of interest) and fractional anisotropy derived from standardized automated tractography-in relation to outcomes. [Participants and Methods] The study design was a retrospective survey of medical records collected from October 2021 to September 2022. Diffusion-tensor imaging was conducted in the second week after stroke onset. Outcomes were assessed using the total score of the motor component of the Stroke Impairment Assessment Set (null to full, 0 to 25). Correlations between fractional anisotropy and the outcomes were then assessed. [Results] Fourteen patients with hemorrhagic stroke were sampled. The fractional anisotropy from standardized automated tractography of the corticospinal tract on the lesion side (mean ± standard deviation, 0.403 ± 0.070) was significantly and tightly correlated (r=0.813) with the outcomes (13.4 ± 9.2), whereas the fractional anisotropy from a region of interest set in the cerebral peduncle on the lesion side (0.548 ± 0.064) was not significantly correlated with the outcomes (r=0.507). [Conclusion] The findings suggest that fractional anisotropy derived from standardized automated tractography can be more applicable to outcome prediction than that derived from a region of interest defined in the standard brain.
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Affiliation(s)
- Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
| | - Midori Mochizuki
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
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Uchiyama Y, Domen K, Koyama T. Brain regions associated with Brunnstrom and functional independence measure scores in patients after a stroke: a tract-based spatial statistics study. J Phys Ther Sci 2023; 35:211-216. [PMID: 36866011 PMCID: PMC9974314 DOI: 10.1589/jpts.35.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/06/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] We aimed to assess diffusion tensor fractional anisotropy to outline the brain regions associated with the long-term motor and cognitive functional outcomes of patients with stroke. [Participants and Methods] Eighty patients from our previous study were enrolled. Fractional anisotropy maps were acquired on days 14-21 after stroke onset, and tract-based spatial statistics were applied. Outcomes were scored using the Brunnstrom recovery stage and Functional Independence Measure motor and cognition components. Fractional anisotropy images were assessed in relation to outcome scores using the general linear model. [Results] For both the right (n=37) and left (n=43) hemisphere lesion groups, the corticospinal tract and the anterior thalamic radiation were most strongly associated with the Brunnstrom recovery stage. In contrast, the cognition component involved large regions encompassing the anterior thalamic radiation, superior longitudinal fasciculus, inferior longitudinal fasciculus, uncinate fasciculus, cingulum bundle, forceps major, and forceps minor. The results for the motor component were intermediate between those for the Brunnstrom recovery stage and those for the cognition component. [Conclusion] Motor-related outcomes were associated with fractional anisotropy decreases in the corticospinal tract, whereas cognitive outcomes were related to broad regions of association and commissural fibers. This knowledge will help scheduling appropriate rehabilitative treatments.
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Affiliation(s)
- Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical
University: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan,Corresponding author. Yuki Uchiyama (E-mail: )
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical
University: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo Medical
University: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan, Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital, Japan
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Mochizuki M, Uchiyama Y, Domen K, Koyama T. Applicability of automated tractography during acute care stroke rehabilitation. J Phys Ther Sci 2023; 35:156-162. [PMID: 36744203 PMCID: PMC9889207 DOI: 10.1589/jpts.35.156] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/22/2022] [Indexed: 02/04/2023] Open
Abstract
[Purpose] To assess the clinical applicability of a novel automated tractography tool named XTRACT during acute stroke rehabilitation. [Participants and Methods] Three patients with left hemisphere stroke were sampled. Diffusion tensor images were acquired on the second week, and automated tractography was then applied. Tractography images and fractional anisotropy (FA) values in the corticospinal tract (CST) and arcuate fasciculus (AF) were assessed in relation to hemiparesis and aphasia. [Results] Patient 1 was nearly asymptomatic; FA in the left CST was 0.610 and that in the AF was 0.509. Patient 2 had severe hemiparesis and mild motor aphasia. Tractography images of the CST and AF were blurred; FA in the left CST was 0.295 and that in the AF was 0.304. Patient 3 showed no hemiparesis or aphasia at initial assessment. Tractography image of the CST was intact but that of the AF was less clear; FA in the left CST was 0.586 and that in the AF was 0.338. Considering the less clear images of the AF and lower FA value in Patients 2 and 3, further examinations for aphasia were performed, which revealed agraphia. [Conclusion] Visualization and quantification of neural fibers using automated tractography promoted planning acute care rehabilitative treatment in patients with stroke.
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Affiliation(s)
- Midori Mochizuki
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan,Corresponding author. Midori Mochizuki (E-mail: )
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan, Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
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邓 宇, 姜 勇, 王 子, 刘 爽, 汪 雨, 刘 宝. [Long short-term memory and Logistic regression for mortality risk prediction of intensive care unit patients with stroke]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:458-467. [PMID: 35701122 PMCID: PMC9197695 DOI: 10.19723/j.issn.1671-167x.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To select variables related to mortality risk of stroke patients in intensive care unit (ICU) through long short-term memory (LSTM) with attention mechanisms and Logistic regression with L1 norm, and to construct mortality risk prediction model based on conventional Logistic regression with important variables selected from the two models and to evaluate the model performance. METHODS Medical Information Mart for Intensive Care (MIMIC)-Ⅳ database was retrospectively analyzed and the patients who were primarily diagnosed with stroke were selected as study population. The outcome was defined as whether the patient died in hospital after admission. Candidate predictors included demogra-phic information, complications, laboratory tests and vital signs in the initial 48 h after ICU admission. The data were randomly divided into a training set and a test set for ten times at a ratio of 8 ∶2. In training sets, LSTM with attention mechanisms and Logistic regression with L1 norm were constructed to select important variables. In the test sets, the mean importance of variables of ten times was used as a reference to pick out the top 10 variables in each of the two models, and then these variables were included in conventional Logistic regression to build the final prediction model. Model evaluation was based on the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. And the model performance was compared with the forward Logistic regression model which hadn't conducted variable selection previously. RESULTS A total of 2 755 patients with 2 979 ICU admission records were included in the analysis, of which 526 recorded deaths. The AUC of Logistic regression model with L1 norm was statistically better than that of LSTM with attention mechanisms (0.819±0.031 vs. 0.760±0.018, P < 0.001). Age, blood glucose, and blood urea nitrogen were at the top ten important variables in both of the two models. AUC, sensitivity, specificity, and accuracy of Logistic regression models were 0.85, 85.98%, 71.74% and 74.26%, respectively. And the final prediction model was superior to forward Logistic regression model. CONCLUSION The variables selected by Logistic regression with L1 norm and LSTM with attention mechanisms had good prediction performance, which showed important implications on the mortality prediction of stroke patients in ICU.
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Affiliation(s)
- 宇含 邓
- 北京大学公共卫生学院社会医学与健康教育学系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 勇 姜
- 国家神经系统疾病临床医学研究中心,首都医科大学附属北京天坛医院神经病学中心,北京 100050China National Clinical Research Center for Neurological Diseases, Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, China
- 北京大数据精准医疗高精尖创新中心(北京航空航天大学&首都医科大学),北京 100070Beijing Advanced Innovation Center for Big Data-Based Precision Medicine (Beihang University & Capital Medical University), Beijing 100070, China
| | - 子尧 王
- 北京大学公共卫生学院社会医学与健康教育学系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 爽 刘
- 北京大学公共卫生学院社会医学与健康教育学系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 雨欣 汪
- 北京大学公共卫生学院社会医学与健康教育学系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 宝花 刘
- 北京大学公共卫生学院社会医学与健康教育学系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
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Chen Y, Wei QC, Zhang MZ, Xie YJ, Liao LY, Tan HX, Guo QF, Gao Q. Cerebellar Intermittent Theta-Burst Stimulation Reduces Upper Limb Spasticity After Subacute Stroke: A Randomized Controlled Trial. Front Neural Circuits 2021; 15:655502. [PMID: 34776874 PMCID: PMC8578104 DOI: 10.3389/fncir.2021.655502] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 09/22/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: This study aims to explore the efficacy of cerebellar intermittent theta-burst stimulation (iTBS) on upper limb spasticity in subacute stroke patients. Methods: A total of 32 patients with upper limb spasticity were enrolled and randomly assigned to treatment with cerebellar iTBS or sham stimulation before conventional physical therapy daily for 2 weeks. The primary outcomes included the modified Ashworth scale (MAS), the modified Tardieu scale (MTS), and the shear wave velocity (SWV). The secondary outcomes were the H-maximum wave/M-maximum wave amplitude ratio (Hmax/Mmax ratio), motor-evoked potential (MEP) latency and amplitude, central motor conduction time (CMCT), and the Barthel Index (BI). All outcomes were evaluated at baseline and after 10 sessions of intervention. Results: After the intervention, both groups showed significant improvements in the MAS, MTS, SWV, and BI. In addition, patients treated with cerebellar iTBS had a significant increase in MEP amplitude, and patients treated with sham stimulation had a significant decrease in Hmax/Mmax ratio. Compared with the sham stimulation group, the MAS, MTS, and SWV decreased more in the cerebellar iTBS group. Conclusion: Cerebellar iTBS is a promising adjuvant tool to reinforce the therapeutic effect of conventional physical therapy in upper limb spasticity management after subacute stroke (Chinese Clinical Trial Registry: ChiCTR1900026516).
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Affiliation(s)
- Yi Chen
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Qing-Chuan Wei
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Ming-Zhi Zhang
- Department of Ultrasound Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yun-Juan Xie
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Ling-Yi Liao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China.,Daping Hospital, Third Military Medical University, Chongqing, China
| | - Hui-Xin Tan
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Qi-Fan Guo
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Qiang Gao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
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Okamoto Y, Ishii D, Yamamoto S, Ishibashi K, Wakatabi M, Kohno Y, Numata K. Relationship Between Motor Function, DTI, and Neurophysiological Parameters in Patients with Stroke in the Recovery Rehabilitation unit. J Stroke Cerebrovasc Dis 2021; 30:105889. [PMID: 34062310 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/08/2021] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES We investigated the relationship between pyramidal tract evaluation indexes (i.e., diffusion tensor imaging, transcranial magnetic stimulation (TMS)-induced motor-evoked potential (MEP), and central motor conduction time (CMCT) on admission to the recovery rehabilitation unit) and motor functions at discharge in patients with ischemic or hemorrhagic stroke. MATERIALS AND METHODS Seventeen patients were recruited (12 men; 57.9 ± 10.3 years). The mean fractional anisotropy (FA) values of the right and left posterior limbs of the internal capsule were estimated using a computer-automated method. We determined the ratios of FA values in the affected and unaffected hemispheres (rFA), TMS-induced MEP, and the ratios of CMCT in the affected and unaffected hemispheres (rCMCT) and examined their association with motor functions (Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT)) at discharge. RESULTS Higher rFA values of the posterior limb of the internal capsule on admission to the recovery rehabilitation unit led to a better recovery of upper limb function (FMA: r = 0.78, p < 0.001; ARAT: r = 0.74, p = 0.001). Patients without MEP had poorer recovery of upper limb function than those with MEP (FMA: p < 0.001; ARAT: p = 0.001). The higher the rCMCT, the poorer the recovery of upper limb function (ARAT: r = -0.93, p < 0.001). However, no association was observed between the pyramidal tract evaluation indexes and recovery of lower limb motor function. CONCLUSIONS Evaluating the pyramidal tract is useful for predicting upper limb function prognosis, but not for lower limb function prognosis.
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Affiliation(s)
- Yoshitaka Okamoto
- Department of Rehabilitation, University of Tsukuba Hospital, 2-1-2, Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Daisuke Ishii
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0394, Japan; Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chiba, Chiba 260-8670, Japan.
| | - Satoshi Yamamoto
- Department of Physical Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0394, Japan
| | - Kiyoshige Ishibashi
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0331, Japan
| | - Masahiro Wakatabi
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0331, Japan
| | - Yutaka Kohno
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0394, Japan
| | - Kenji Numata
- Department of Physical Therapy, Tokyo Professional University of Health Sciences, 2-22-10 Shiohama, Koto-ku, Tokyo 135-0043, Japan
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Yasukawa T, Koyama T, Uchiyama Y, Iwasa S, Saito J, Takahashi J, Kiritani N, Domen K. Outcome prediction in patients with putaminal hemorrhage at admission to a convalescent rehabilitation ward based on hemorrhage volume assessed with computed tomography during acute care. J Phys Ther Sci 2021; 33:27-31. [PMID: 33519070 PMCID: PMC7829568 DOI: 10.1589/jpts.33.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/02/2020] [Indexed: 11/30/2022] Open
Abstract
[Purpose] The aim of this study was to assess the usefulness of computed tomography for
outcome prediction in patients with putaminal hemorrhage at admission to a convalescent
rehabilitation ward. [Participants and Methods] Patients admitted to our convalescent
rehabilitation ward after transfer from acute care hospitals were included in this study.
Multiple regression analyses were performed using the score in the motor component of the
Functional Independence Measure at discharge as the target value. Hemorrhage volume
assessed with computed tomography during acute care and age were set as the explanatory
variables. The motor component of the Functional Independence Measure score at admission
and the time (days) from onset were also recorded. Correlation analyses between all the
possible pairs of explanatory variables were then performed. [Results] Hemorrhage volume
and age were both significant contributors to the motor component of the Functional
Independence Measure score at discharge. However, the contribution of hemorrhage volume
disappeared when the time from onset and motor component of the Functional Independence
Measure score at admission were added. Hemorrhage volume significantly correlated with the
time from onset and motor component of the Functional Independence Measure score at
admission. [Conclusion] The present findings suggest that computed tomography may be
useful for outcome prediction from the acute stage in stroke patients with putaminal
hemorrhage. However, because of multicollinearity, its predictive power was reduced when
the patients were transferred to a convalescent rehabilitation ward.
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Affiliation(s)
- Toshiki Yasukawa
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.,Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Saya Iwasa
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jun Saito
- Department of Rehabilitation Medicine, Rakusai Shimizu Hospital, Japan
| | - Jun Takahashi
- Department of Rehabilitation Medicine, Rakusai Shimizu Hospital, Japan
| | - Naoko Kiritani
- Department of Rehabilitation Medicine, Rakusai Shimizu Hospital, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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