Effectiveness of Home- and Community-Based Rehabilitation in a Large Cohort of Patients Disabled by Cerebrovascular Accident: Evidence of a Dose-Response Relationship

Abstract Objectives To (1) assess the effectiveness of home- and community-based rehabilitation (HCBR) in a large cohort of individuals with disabilities secondary to cerebrovascular accident (CVA); and (2) evaluate the responsiveness to treatment of the Mayo-Portland Adaptability Inventory (MPAI-4)...

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Veröffentlicht in:Archives of physical medicine and rehabilitation 2013-09, Vol.94 (9), p.1837-1841
Hauptverfasser: Altman, Irwin M., PhD, MBA, Swick, Shannon, MA, Malec, James F., PhD, ABPP-Cn, Rp
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Sprache:eng
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Zusammenfassung:Abstract Objectives To (1) assess the effectiveness of home- and community-based rehabilitation (HCBR) in a large cohort of individuals with disabilities secondary to cerebrovascular accident (CVA); and (2) evaluate the responsiveness to treatment of the Mayo-Portland Adaptability Inventory (MPAI-4) to changes resulting from HCBR in this patient group. Design Retrospective analysis of program evaluation data for treatment completers and noncompleters. Setting HCBR conducted in 7 geographically distinct U.S. cities. Participants Individuals with CVA (n=738) who completed the prescribed course of rehabilitation (completed course of treatment [CCT]) compared with 150 individuals who were precipitously discharged (PD) before program completion. Intervention HCBR delivered by certified professional staff on an individualized basis. Main Outcome Measures Mayo-Portland Adaptability Inventory (MPAI-4) completed by professional consensus on admission and at discharge. Results With the use of analysis of covariance, MPAI-4 total scores at discharge for CCT participants were compared with those of PD participants, with admission MPAI-4, age, length of stay, and time since event as covariates. CCT participants showed greater improvement than PD participants (F=99.48, P
ISSN:0003-9993
1532-821X
DOI:10.1016/j.apmr.2013.02.014