title: The effect of additional training on motor outcomes at discharge from recovery phase rehabilitation wards: a survey from multi-center stroke data bank in Japan.
abstract: OBJECTIVE
  The purpose of the present study was to examine the potential benefits of additional training in patients admitted to recovery phase rehabilitation ward using the data bank of post-stroke patient registry.
  
  
  METHODS
  Subjects were 2507 inpatients admitted to recovery phase rehabilitation wards between November 2004 and November 2010. Participants were retrospectively divided into four groups based upon chart review; patients who received no additional rehabilitation, patients who were added with self-initiated off hours training, patients who were added with off hours training by ward staff, patients who received both self-initiated training and training by ward staff. Parameters for assessing outcomes included length of stay, motor/cognitive subscales of functional independent measures (FIM) and motor benefit of FIM calculated by subtracting the score at admission from that at discharge.
  
  
  RESULTS
  Participants were stratified into three groups depending on the motor FIM at admission (≦28, 29∼56, 57≦) for comparison. Regarding outcome variables, significant inter-group differences were observed in all items examined within the subgroup who scored 28 or less and between 29 and 56. Meanwhile no such trends were observed in the group who scored 57 or more compared with those who scored less. In a decision tree created based upon Exhaustive Chi-squared Automatic Interaction Detection method, variables chosen were the motor FIM at admission (the first node) additional training (the second node), the cognitive FIM at admission(the third node).
  
  
  CONCLUSIONS
  Overall the results suggest that additional training can compensate for the shortage of regular rehabilitation implemented in recovery phase rehabilitation ward, thus may contribute to improved outcomes assessed by motor FIM at discharge.
authors.affiliation: Department of Geriatrics, Medicine in Growth and Aging, Program in Health and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Rehabilitation, Faculty of Health Science, Nihon Fukushi University, Nagoya, Japan.
authors.forename: Nariaki
authors.initials: N
authors.lastname: Shiraishi
authors.affiliation: Department of Comprehensive Community Care Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, Kio University, Koryo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumoto
authors.affiliation: Department of Social Science Center for Gerontology and Social Science, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Seungwon
authors.initials: S
authors.lastname: Jeong
authors.affiliation: Department of Rehabilitation, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Motoya
authors.initials: M
authors.lastname: Sugiyama
authors.affiliation: Center for Well-being and Society, Nihon Fukushi University, Nagoya, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kondo
authors.affiliation: Department of Geriatrics, Medicine in Growth and Aging, Program in Health and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuzuya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D010351:Patient Discharge; D063868:Patient Outcome Assessment; D020127:Recovery of Function; D012047:Rehabilitation Centers; D020521:Stroke / Q000503:physiopathology / Q000628:therapy; D000071939:Stroke Rehabilitation