Subcortical Vascular Lesions Predict Functional Recovery After Rehabilitation in Patients with L‐Dopa Refractory Parkinsonism
Identifieur interne : 001574 ( Main/Exploration ); précédent : 001573; suivant : 001575Subcortical Vascular Lesions Predict Functional Recovery After Rehabilitation in Patients with L‐Dopa Refractory Parkinsonism
Auteurs : Fabio Guerini [Italie] ; Giovanni B. Frisoni [Italie] ; Catherine Bellwald [Italie] ; Roberta Rossi Psy [Italie] ; Giuseppe Bellelli [Italie] ; Marco Trabucchi [Italie]Source :
- Journal of the American Geriatrics Society [ 0002-8614 ] ; 2004-02.
English descriptors
Abstract
Objectives: To identify predictors of functional recovery after an intensive rehabilitation training in patients with gait disturbances and refractory parkinsonism. Design: Observational study. Setting: A hospital geriatric rehabilitation department (“Ancelle della Carità” hospital of Cremona). Participants: Thirty‐eight subjects (mean age±standard deviation of 78.9±6.5; 66% women) with gait disturbances and L‐dopa refractory parkinsonism consecutively admitted to a rehabilitation unit within 6 months were recruited. Exclusion criteria were obvious musculoskeletal disorders (severe leg arthritis, hemiparesis, recent stroke), recent surgery, delirium, physical impairment from other identifiable causes, and missing computed tomography (CT) scan. All subjects received an intensive standardized rehabilitative program including conventional physical therapy and specific gait training. Measurements: The outcome measure of the rehabilitation training was the gain between admission and discharge on the Unified Parkinson Disease Rating Scale (delta‐UPDRS). The following potential predictors were assessed using comprehensive geriatric assessment: physical health (Charlson Comorbidity Index, number of drugs), cognitive performance (Mini‐Mental State Examination (MMSE)), functional status (Tinetti scale), depressive symptoms (Geriatric Depression Scale), nutritional status (serum albumin and body mass index), and subcortical cerebrovascular load (four classes of increasing severity based on diffuse leukoariosis, patchy lesions of the white matter, and lacunas on CT scan). Multivariate logistic regression with fixed adjustment for age, cognitive performance, and UPDRS on admission and stepwise selection of variables were used to identify independent predictors. Results: Patients were divided into two groups of equal size based on the delta‐UPDRS (high and low functional recovery: delta‐UPDRS >8 and ≤8, respectively). Of all variables, only subcortical cerebrovascular load predicted functional recovery at discharge (odds ratio adjusted for age, MMSE, and UPDRS on admission=2.3, 95% confidence interval=1.0–5.1). The adjusted proportion of patients with high functional recovery decreased with increasing subcortical cerebrovascular load: 83%, 61%, 44%, and 27% (adjusted P for trend=0.047). Conclusion: Subcortical cerebrovascular load is a predicting factor of successful rehabilitation in patients with L‐dopa refractory parkinsonism.
Url:
DOI: 10.1111/j.1532-5415.2004.52064.x
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Subcortical Vascular Lesions Predict Functional Recovery After Rehabilitation in Patients with L‐Dopa Refractory Parkinsonism</title><author><name sortKey="Guerini, Fabio" sort="Guerini, Fabio" uniqKey="Guerini F" first="Fabio" last="Guerini">Fabio Guerini</name></author><author><name sortKey="Frisoni, Giovanni B" sort="Frisoni, Giovanni B" uniqKey="Frisoni G" first="Giovanni B." last="Frisoni">Giovanni B. Frisoni</name></author><author><name sortKey="Bellwald, Catherine" sort="Bellwald, Catherine" uniqKey="Bellwald C" first="Catherine" last="Bellwald">Catherine Bellwald</name></author><author><name sortKey="Psy, Roberta Rossi" sort="Psy, Roberta Rossi" uniqKey="Psy R" first="Roberta Rossi" last="Psy">Roberta Rossi Psy</name></author><author><name sortKey="Bellelli, Giuseppe" sort="Bellelli, Giuseppe" uniqKey="Bellelli G" first="Giuseppe" last="Bellelli">Giuseppe Bellelli</name></author><author><name sortKey="Trabucchi, Marco" sort="Trabucchi, Marco" uniqKey="Trabucchi M" first="Marco" last="Trabucchi">Marco Trabucchi</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:6BAAF5138EB35E869AC3A6ACFACCBA50D53CE9F1</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1111/j.1532-5415.2004.52064.x</idno><idno type="url">https://api.istex.fr/document/6BAAF5138EB35E869AC3A6ACFACCBA50D53CE9F1/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002F40</idno><idno type="wicri:Area/Main/Curation">002B50</idno><idno type="wicri:Area/Main/Exploration">001574</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Subcortical Vascular Lesions Predict Functional Recovery After Rehabilitation in Patients with L‐Dopa Refractory Parkinsonism</title><author><name sortKey="Guerini, Fabio" sort="Guerini, Fabio" uniqKey="Guerini F" first="Fabio" last="Guerini">Fabio Guerini</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>From the*Rehabilitation Unit “Ancelle della Carità” Hospital, Cremona, Italy†Geriatric Research Group, Brescia, Italy‡Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio Fatabenefratelli, Brescia, Italy§“Tor Vergata” University, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Frisoni, Giovanni B" sort="Frisoni, Giovanni B" uniqKey="Frisoni G" first="Giovanni B." last="Frisoni">Giovanni B. Frisoni</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>From the*Rehabilitation Unit “Ancelle della Carità” Hospital, Cremona, Italy†Geriatric Research Group, Brescia, Italy‡Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio Fatabenefratelli, Brescia, Italy§“Tor Vergata” University, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Bellwald, Catherine" sort="Bellwald, Catherine" uniqKey="Bellwald C" first="Catherine" last="Bellwald">Catherine Bellwald</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>From the*Rehabilitation Unit “Ancelle della Carità” Hospital, Cremona, Italy†Geriatric Research Group, Brescia, Italy‡Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio Fatabenefratelli, Brescia, Italy§“Tor Vergata” University, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Psy, Roberta Rossi" sort="Psy, Roberta Rossi" uniqKey="Psy R" first="Roberta Rossi" last="Psy">Roberta Rossi Psy</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>From the*Rehabilitation Unit “Ancelle della Carità” Hospital, Cremona, Italy†Geriatric Research Group, Brescia, Italy‡Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio Fatabenefratelli, Brescia, Italy§“Tor Vergata” University, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Bellelli, Giuseppe" sort="Bellelli, Giuseppe" uniqKey="Bellelli G" first="Giuseppe" last="Bellelli">Giuseppe Bellelli</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>From the*Rehabilitation Unit “Ancelle della Carità” Hospital, Cremona, Italy†Geriatric Research Group, Brescia, Italy‡Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio Fatabenefratelli, Brescia, Italy§“Tor Vergata” University, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Trabucchi, Marco" sort="Trabucchi, Marco" uniqKey="Trabucchi M" first="Marco" last="Trabucchi">Marco Trabucchi</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>From the*Rehabilitation Unit “Ancelle della Carità” Hospital, Cremona, Italy†Geriatric Research Group, Brescia, Italy‡Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio Fatabenefratelli, Brescia, Italy§“Tor Vergata” University, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of the American Geriatrics Society</title><idno type="ISSN">0002-8614</idno><idno type="eISSN">1532-5415</idno><imprint><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2004-02">2004-02</date><biblScope unit="volume">52</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="252">252</biblScope><biblScope unit="page" to="256">256</biblScope></imprint><idno type="ISSN">0002-8614</idno></series><idno type="istex">6BAAF5138EB35E869AC3A6ACFACCBA50D53CE9F1</idno><idno type="DOI">10.1111/j.1532-5415.2004.52064.x</idno><idno type="ArticleID">JGS52064</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-8614</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>functional recovery</term><term>parkinsonism</term><term>rehabilitation</term><term>subcortical vascular lesions</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objectives: To identify predictors of functional recovery after an intensive rehabilitation training in patients with gait disturbances and refractory parkinsonism. Design: Observational study. Setting: A hospital geriatric rehabilitation department (“Ancelle della Carità” hospital of Cremona). Participants: Thirty‐eight subjects (mean age±standard deviation of 78.9±6.5; 66% women) with gait disturbances and L‐dopa refractory parkinsonism consecutively admitted to a rehabilitation unit within 6 months were recruited. Exclusion criteria were obvious musculoskeletal disorders (severe leg arthritis, hemiparesis, recent stroke), recent surgery, delirium, physical impairment from other identifiable causes, and missing computed tomography (CT) scan. All subjects received an intensive standardized rehabilitative program including conventional physical therapy and specific gait training. Measurements: The outcome measure of the rehabilitation training was the gain between admission and discharge on the Unified Parkinson Disease Rating Scale (delta‐UPDRS). The following potential predictors were assessed using comprehensive geriatric assessment: physical health (Charlson Comorbidity Index, number of drugs), cognitive performance (Mini‐Mental State Examination (MMSE)), functional status (Tinetti scale), depressive symptoms (Geriatric Depression Scale), nutritional status (serum albumin and body mass index), and subcortical cerebrovascular load (four classes of increasing severity based on diffuse leukoariosis, patchy lesions of the white matter, and lacunas on CT scan). Multivariate logistic regression with fixed adjustment for age, cognitive performance, and UPDRS on admission and stepwise selection of variables were used to identify independent predictors. Results: Patients were divided into two groups of equal size based on the delta‐UPDRS (high and low functional recovery: delta‐UPDRS >8 and ≤8, respectively). Of all variables, only subcortical cerebrovascular load predicted functional recovery at discharge (odds ratio adjusted for age, MMSE, and UPDRS on admission=2.3, 95% confidence interval=1.0–5.1). The adjusted proportion of patients with high functional recovery decreased with increasing subcortical cerebrovascular load: 83%, 61%, 44%, and 27% (adjusted P for trend=0.047). Conclusion: Subcortical cerebrovascular load is a predicting factor of successful rehabilitation in patients with L‐dopa refractory parkinsonism.</div></front></TEI><affiliations><list><country><li>Italie</li></country><region><li>Latium</li></region><settlement><li>Rome</li></settlement></list><tree><country name="Italie"><region name="Latium"><name sortKey="Guerini, Fabio" sort="Guerini, Fabio" uniqKey="Guerini F" first="Fabio" last="Guerini">Fabio Guerini</name></region><name sortKey="Bellelli, Giuseppe" sort="Bellelli, Giuseppe" uniqKey="Bellelli G" first="Giuseppe" last="Bellelli">Giuseppe Bellelli</name><name sortKey="Bellwald, Catherine" sort="Bellwald, Catherine" uniqKey="Bellwald C" first="Catherine" last="Bellwald">Catherine Bellwald</name><name sortKey="Frisoni, Giovanni B" sort="Frisoni, Giovanni B" uniqKey="Frisoni G" first="Giovanni B." last="Frisoni">Giovanni B. Frisoni</name><name sortKey="Psy, Roberta Rossi" sort="Psy, Roberta Rossi" uniqKey="Psy R" first="Roberta Rossi" last="Psy">Roberta Rossi Psy</name><name sortKey="Trabucchi, Marco" sort="Trabucchi, Marco" uniqKey="Trabucchi M" first="Marco" last="Trabucchi">Marco Trabucchi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001574 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 001574 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= ParkinsonV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:6BAAF5138EB35E869AC3A6ACFACCBA50D53CE9F1
|texte= Subcortical Vascular Lesions Predict Functional Recovery After Rehabilitation in Patients with L‐Dopa Refractory Parkinsonism
}}
| This area was generated with Dilib version V0.6.23. |  |