 |
 |
 |
 |
 |
 |
 |
 |
 |
R10. Stroke Rehabilitation Database: Characteristics, Course, Care and Cost
Stroke outcomes are determined by multiple distinguish-able factors that are related to each other in subtle but complex ways. While the relative influence of individual biologic, per-sonal, and social factors on outcome and resource utilization following stroke has been the focus of consider-able clinical activity and academic debate, no single model has been developed that considers all of these influences collectively. A number of well-designed univariate and multi-variate studies have exam-ined the roles of impair-ment, disability, motivation, and social support individually in predicting out-comes for stroke survivors. While these studies have allowed detailed exam-ination of individual el-ements, such as, severity of disability or medical complications, this anal-ysis does not give a full picture of the multiple factors and relationships affecting quality of life and com-munity reintegra-tion. The multidimensional nature of the problems with which stroke patients pre-sent, to-gether with the holistic way in which stroke rehabilitation is practiced, suggest that the evaluation of po-tential influences affecting the course, care, and cost of stroke patients undergoing rehabilita-tion must be more comprehensive.
The specific aims of this project are: 1) to study and compare clinical features and rehabilitation outcomes of stroke survivors treated in a variety of clinical settings, including an urban academic free-standing re-ha-bili-tation hospital, urban and suburban community hospital-based rehabilitation units, a rural community hospital-based rehabilitation unit, and several subacute reha-bilitation units; and 2) to de-termine the relative impact and interactions among type and level of impairment, disability, mood, associated medical conditions, perceived health status, social sup-port, and environmental barriers in determining stroke outcomes after stroke rehabilitation.
Publications:Roth, E. J. & Lovell, L. Report of the RIC Stroke Rehabilitation Database: The 7-year experience. Topics in Stroke Rehabilitation, in press.
Roth, E.J., Lovell, L., Harvey, R.L., Bode, R.K., & Heinemann, A.W. (2002). Rehabilitation: Indwelling Urinary Catheters, Enteral Feeding Tubes and Tracheostomies are Associated with Resource Utilization and Functional Outcomes of and risk factors for medical complications during stroke rehabilitation. Stroke, 33(7),1845-50.
Roth, E.J., Lovell, L., Harvey, R.L., Heinemann, A.W., Semik, P., & Diaz, S. (2001). Incidence of and risk factors for medical complications during stroke rehabilitation. Stroke, 32(2), 523-529.
Roth, E.J., Heinemann, A.W., Lovell, L.L., Harvey, R.L., McGuire, J.R., & Diaz, S. (1998). Impairment and disability: their relation during stroke rehabilitation. Archives of Physical Medicine and Rehabilitation, 79(3), 329-35.
Harvey, R.L., Roth, E.J., Heinemann, A.W., Lovell, L.L., McGuire, J.R., & Diaz, S. (1998). Stroke rehabilitation: clinical predictors of resource utilization. Archives of Physical Medicine and Rehabilitation, 79(11), 1349-55.
Heinemann, A.W., Harvey, R.L., McGuire, J.R., Ingberman, D., Lovell, L.L., Semik, P., & Roth, E.J. (1997). Measurement properties of the NIH Stroke Scale during acute rehabilitation. Stroke, 26(6), 1174-80.