Tabla I. Asociación de factores y evaluaciones en el momento inicial y final (comparación de medias entre categorías; valor de p). |
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TIS total |
TIS equilibrio |
TIS coordinación |
PASS total |
PASS movilidad |
PASS equilibrio |
FAC |
Tinetti total |
Tinetti equilibrio |
Tinetti marcha |
|
Momento inicial |
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Sexo |
0,865 |
0,688 |
0,757 |
0,803 |
0,861 |
0,716 |
0,561 |
0,837 |
0,779 |
0,933 |
Régimen de rehabilitación |
0,107 |
0,343 |
0,012a |
0,031a |
0,049a |
0,02a |
0,018a |
0,018a |
0,01b |
0,061 |
Etiología |
0,62 |
0,451 |
0,913 |
0,174 |
0,322 |
0,055 |
0,301 |
0,101 |
0,078 |
0,185 |
Lateralidad |
0,855 |
0,866 |
0,455 |
0,764 |
0,749 |
0,808 |
0,446 |
0,609 |
0,607 |
0,650 |
Localización |
0,237 |
0,168 |
0,723 |
0,839 |
0,876 |
0,52 |
0,934 |
0,905 |
0,867 |
0,910 |
Hipertensión arterial |
0,38 |
0,302 |
0,707 |
0,633 |
0,422 |
0,886 |
0,462 |
0,773 |
0,671 |
0,941 |
Diabetes mellitus |
0,62 |
0,714 |
0,536 |
0,031 |
0,044 |
0,025 |
0,187 |
0,074 |
0,045 |
0,184 |
Dislipidemia |
0,074 |
0,093 |
0,122 |
0,004b |
0,003b |
0,017a |
0,005b |
0,006b |
0,013a |
0,004b |
Hábito tabáquico |
0,271 |
0,222 |
0,500 |
0,774 |
0,743 |
0,787 |
0,567 |
0,604 |
0,603 |
0,420 |
Medicación psicótropa |
0,177 |
0,261 |
0,148 |
0,092 |
0,087 |
0,134 |
0,38 |
0,234 |
0,203 |
0,331 |
Momento final |
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Sexo |
0,455 |
0,251 |
0,926 |
0,832 |
0,902 |
0,496 |
0,191 |
0,317 |
0,294 |
0,312 |
Régimen de rehabilitación |
0,039a |
0,295 |
0b |
0,134 |
0,157 |
0,13 |
0,057 |
0,109 |
0,121 |
0,139 |
Etiología |
0,660 |
0,983 |
0,276 |
0,193 |
0,223 |
0,185 |
0,142 |
0,145 |
0,154 |
0,160 |
Lateralidad |
0,534 |
0,473 |
0,751 |
0,773 |
0,930 |
0,581 |
0,901 |
0,972 |
0,937 |
0,866 |
Localización |
0,511 |
0,679 |
0,414 |
0,503 |
0,557 |
0,431 |
0,826 |
0,774 |
0,64 |
0,871 |
Hipertensión arterial |
0,504 |
0,419 |
0,770 |
0,379 |
0,294 |
0,565 |
0,796 |
0,95 |
0,859 |
0,780 |
Diabetes mellitus |
0,607 |
0,822 |
0,357 |
0,235 |
0,268 |
0,223 |
0,192 |
0,115 |
0,121 |
0,155 |
Dislipidemia |
0,168 |
0,292 |
0,093 |
0,025a |
0,027a |
0,033a |
0,007b |
0,045a |
0,056 |
0,049a |
Hábito tabáquico |
0,827 |
0,964 |
0,429 |
0,991 |
0,917 |
0,923 |
0,921 |
0,733 |
0,791 |
0,668 |
Medicación psicótropa |
0,036* |
0,105 |
0,012a |
0,028a |
0,047a |
0,019a |
0,068 |
0,063 |
0,054 |
0,111 |
FAC: Functional Ambulation Categories; PASS: Postural Assessment Scale for Stroke; TIS: Trunk Impairment Scale. a p < 0,05; b p < 0,01. |
Tabla II. Correlación entre las escalas finales e iniciales. |
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Escalas finales |
Escalas iniciales |
Término independiente |
R2 |
|
TIS total |
TIS total (0,781)b |
Tinetti equilibrio (0,292)b |
2,022 |
0,751 |
TIS equilibrio |
TIS total (0,540)b |
FAC (0,504)a |
1,530 |
0,683 |
TIS coordinación |
TIS coordinación (0,753)b |
Tinetti equilibrio (0,130)b |
0,559 |
0,703 |
PASS total |
PASS total (0,704)b |
TIS equilibrio (0,647)b |
8,655 |
0,818 |
PASS movilidad |
PASS movilidad (0,767)b |
5,897 |
0,803 |
|
PASS equilibrio |
PASS equilibrio (0,716)b |
TIS equilibrio (0,407)b |
2,724 |
0,760 |
FAC |
TIS equilibrio (0,211)b |
Tinetti total (0,138)b |
0,301 |
0,727 |
Tinetti total |
Tinetti total (0,835)b |
TIS total (0,784)b |
2,852 |
0,742 |
Tinetti equilibrio |
Tinetti equilibrio (0,777)b |
TIS total (0,459)b |
1,786 |
0,758 |
Tinetti marcha |
Tinetti total (0,362)b |
TIS total (0,337)b |
0,873 |
0,697 |
FAC: Functional Ambulation Categories; PASS: Postural Assessment Scale for Stroke; TIS: Trunk Impairment Scale. a p < 0,05; b p < 0,01. |
Tabla III. Modelos de regresión lineal múltiple para cada escala después de dos meses de rehabilitación. |
|
R2 |
|
TIS total (final) = 2,022 + (0,781 × TIS total inicial) + (0,292 × Tinetti equilibrio inicial) |
0,751 |
PASS total (final) = 8,655 + (0,704 × PASS total inicial) + (0,647 × TIS equilibrio inicial) |
0,818 |
FAC (final) = 0,301 + (0,211 × TIS equilibrio inicial) + (0,138 × Tinetti total inicial) |
0,727 |
Tinetti total (final) = 2,852 + (0,835 × Tinetti total inicial) + (0,784 × TIS total inicial) |
0,742 |
FAC: Functional Ambulation Categories; PASS: Postural Assessment Scale for Stroke; TIS: Trunk Impairment Scale. |
Postural control and gait changes in subacute stroke patients after receiving interdisciplinary rehabilitation and related factors: a retrospective study Introduction. Although early post-stroke rehabilitation is essential to optimize recovery, its effects and prognostic factors are yet under discussion. Objective. To assess postural control and gait changes in post-stroke patients who underwent interdisciplinary rehabilitation in subacute phase and evaluate potential associated factors. Patients and methods. An observational retrospective study that analyzed sociodemographic and clinical data, including Trunk Impairment Scale (TIS), Postural Assessment Scale for Stroke (PASS), Functional Ambulatory Categories (FAC) and Tinetti scale, at admission and two months after rehabilitation. Results. Data were collected from 63 patients with stroke in subacute phase. Interdisciplinary rehabilitation had a moderate and relevant clinical impact (p < 0,01; d > 0,5) in postural control and gait. Ambulatory rehabilitation, psychotropic medication absence and dislipemia absence were moderate associated factors (p < 0,05; d > 0,5) with a greater evolution in postural control measured with TIS and PASS. TIS at admission showed significant association with all scales’ results at two months after rehabilitation, except with PASS changing posture subscale. Conclusions. Interdisciplinary rehabilitation promotes moderate and clinically relevant changes in postural control and gait recovery in subacute stroke patients, after two-month rehabilitation period. Ambulatory rehabilitation, dyslipidemia absence and psychotropic medication absence were associated with patients’ evolution, but further research is required to confirm their actual influence in larger samples. Key words. Gait. Interdisciplinary rehabilitation. Movement disorders. Postural control. Predictive validity. Stroke. |