Investigation of inpatient convalescent rehabilitation outcomes in branch atheromatous disease (BAD)

Abstract

Purpose: We investigated inpatient convalescent rehabilitation outcomes of ischemic stroke especially for branch atheromatous disease (BAD).Subjects and Methods: Subjects were 90 lenticulostriate artery territory-BAD (LSA-BAD) and 21 paramedian pontine artery territory-BAD (PPA-BAD) patients. For all patients, National Institutes of Health Stroke Scale (NIHSS) and functional independence measure (FIM) scores, and Brunnstrom stages (BRS) of upper limb, fingers, and lower limb were measured both on admission and discharge.Results: There were no significant differences in clinical scores and characteristics on admission between LSA-BAD and PPA-BAD groups except for the higher proportion of female in PPA-BAD groups (p=0.043). The severities of PPA-BAD patients with NIHSS scores were significantly mild compared with those of LSA-BAD patients on admission (p=0.031) and at discharge (p=0.008). Significant lower improvements with LSA-BAD patients were found in the stages of BRS with upper limb (p=0.009) and fingers (p=0.010) at discharge and recovery changes of BRS with fingers (p=0.031) compared with those of PPA-BAD patients. The improvements of each BRS score with LSA-BAD patients had the tendency of the limitations within two up-grades however both LSA-BAD and PPA-BAD patients basically gained over 100 total-FIM scores at discharge.Conclusion: The investigation of rehabilitation outcomes with BAD patients in the convalescent period can assess the improvements of pure-motor hemiparesis and activities of daily living, because the disturbance of the corticospinal tract by ischemic infarction lesions may be different in LSA-BAD and PPA-BAD.