Improved functional independence measure facilitates return to home after paralyzed upper-limb training: a case report.
Kuniaki Nagai, Fumiaki Yamaguchi
PMID 28603380WHAT IT FOUND
The FIM score rose from 71 to 105 in one stroke patient who received occupational therapy, affected upper-limb training, physiotherapy, and a fixed walker with knee support over four months.
She returned home. This is one person, not proof the package works.
Key findings
01The FIM score improved from 71 at the initial assessment to 100 by day 119 and to 105 by day 170.
02Seven FIM items improved, including cleaning the body, changing clothes for tops and bottoms, toileting, transferring to bed, chair, and wheelchair, transferring to the toilet, and moving by walking and wheelchair.
03On day 170, the team reviewed progress with her family, and she was discharged and returned home.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a case report about one patient, so it describes what happened to her and cannot show that the training caused improvement. Several treatments and supports were given together, including occupational therapy, affected upper-limb training, physiotherapy, a fixed walker, knee support, and family and social support, so the contribution of any single component cannot be separated. The report does not include a comparison group, randomisation, or blinding. Her intact cognition, motivation, family support, and social resources may also have contributed to her progress and discharge. Her knee osteoarthritis, low back pain, and prior limited mobility make it unclear how her response applies to other stroke patients. The discharge decision depended on her general condition, physical abilities, living environment, and social resources, not only on FIM scores.
Declared interests
The authors reported no conflicts of interest, and no funding was listed.
The easy way to misread this
Do not conclude that affected upper-limb training alone caused the FIM improvement or the return home. This was one patient who received occupational therapy, affected upper-limb training, physiotherapy, a fixed walker, knee support, and family and social support together, and the report cannot separate those contributions.