Length of stay in the rehabilitation hospital required for the attainment of functional goals in adult patients after cerebrovascular accidents Miwako Nakamura 1 , Misao Ogano 1 , Yasuyoshi Takeda 1 , Naoko Makino 1 , Toshinori Matsufusa 2 1Nozomi Hospital 2College of Medical Care and Technology, Gunma University Keyword: 脳血管障害 , 機能的ゴール , リハゴール , cerebrovascular accidents , functional goals , rehabilitation goals pp.98-104
Published Date 1997/4/15
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 For adults who have suffered cerebrovascular accidents (CVA), it has been said that their physical impairments become fixed at about six months from onset. However, there are few studies which attempt to examine the legitimacy of this notion. In this study, data on CVA inpatients at Nozomi Hospital were analyzed to determine : (1) whether they show functional changes either during or after the first 180 days following the onset of stroke, and (2) when a functional plateau can be said to have been reached. This study utilized demographic data, findings from medical records, and results of functional tests, including the Motor Age Test, the Mini-Mental State Examination, and the Barthel ADL Index. To acquire empirical data for verification of (1), T-tests of these indices were administered to eighty-six patients. The results revealed significant changes in tested functions both during and after the initial 180 day period. Analysis of data on an expanded group of 228 patients showed that they generally reached their functional plateau at six months after the onset of CVA, or three months after their hospitalization. More variation was noted when measuring from the onset of CVA than when measuring from the start of hospitalization.

 Case examples are also presented to show the reasons why some patients needed long-term rehabilitative treatments. Patients with severe physical problems, cognitive deficits, internal diseases, and/or secondary problems due to functional disuse or misuse seemed to require longer times of rehabilitation to reach their maximum ADL skills. A young patient with a memory deficit who stayed in the hospital more than seven months from the onset of CVA in order to receive prevocational training is also presented. The length of rehabilitation treatment and its goals should be determined following careful evaluation of the patients' physical and cognitive states.

Copyright © 1997, Japanese Association of Occupational Therapists. All rights reserved.


電子版ISSN 印刷版ISSN 0289-4920 日本作業療法士協会