Deans' stroke musings: Clinical Management Provided by Board-Certificated Physiatrists in Early Rehabilitation Is a Significant Determinant of Functional Improvement in Acute Stroke Patients: A Retrospective Analysis of Japan Rehabilitation Database

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, March 28, 2015

Clinical Management Provided by Board-Certificated Physiatrists in Early Rehabilitation Is a Significant Determinant of Functional Improvement in Acute Stroke Patients: A Retrospective Analysis of Japan Rehabilitation Database

This is just so f*cking self-servingly wrong. They are incredibly incompetent if this is their conclusion. All recovery in the early weeks is spontaneous, having NOTHING to do with the attending physician. Just because someone is standing next to Michael Jordan as he makes a basket is no reason to attribute any of that to you standing next to him. And these people have MD and doctorates behind their names.
http://www.sciencedirect.com/science/article/pii/S1052305714006399

Shoji Kinoshita, MD,
Wataru Kakuda, MD, PhD,
Ryo Momosaki, MD, PhD,
Naoki Yamada, MD,
Hidekazu Sugawara, MD, PhD,
Shu Watanabe, MD, PhD,
Masahiro Abo, MD, PhD^,

Background

Early rehabilitation for acute stroke patients is widely recommended. We tested the hypothesis that clinical outcome of stroke patients who receive early rehabilitation managed by board-certificated physiatrists (BCP) is generally better than that provided by other medical specialties.

Methods

Data of stroke patients who underwent early rehabilitation in 19 acute hospitals between January 2005 and December 2013 were collected from the Japan Rehabilitation Database and analyzed retrospectively. Multivariate linear regression analysis using generalized estimating equations method was performed to assess the association between Functional Independence Measure (FIM) effectiveness and management provided by BCP in early rehabilitation. In addition, multivariate logistic regression analysis was also performed to assess the impact of management provided by BCP in acute phase on discharge destination.

Results

After setting the inclusion criteria, data of 3838 stroke patients were eligible for analysis. BCP provided early rehabilitation in 814 patients (21.2%). Both the duration of daily exercise time and the frequency of regular conferencing were significantly higher for patients managed by BCP than by other specialties. Although the mortality rate was not different, multivariate regression analysis showed that FIM effectiveness correlated significantly and positively with the management provided by BCP (coefficient, .35; 95% confidence interval [CI], .012-.059; P < .005). In addition, multivariate logistic analysis identified clinical management by BCP as a significant determinant of home discharge (odds ratio, 1.24; 95% CI, 1.08-1.44; P < .005).

Conclusions

Our retrospective cohort study demonstrated that clinical management provided by BCP in early rehabilitation can lead to functional recovery of acute stroke.