[article]
| Titre : |
GABAergic drug use and global, cognitive, and motor functional outcomes after stroke |
| Type de document : |
texte imprimé |
| Auteurs : |
A.J.-P. Schwitzguébel ; Charles Benaïm ; Stefano Carda ; [et al...] |
| Année de publication : |
2016 |
| Article en page(s) : |
p. 320-325 |
| Langues : |
Français (fre) |
| Mots-clés : |
Recovery Rehabilitation Stroke GABA-A receptor agonists Benzodiazepines Minimal clinically important difference Functional independence measure |
| Résumé : |
Background
In animal models and healthy volunteers, the use of GABA A receptor agonists (GABA-AGs) seem deleterious for functional recovery. The agents are widely used for subacute stroke, but their effect on functional recovery remains unclear.
Objectives
We aimed to evaluate the association between GABA-AG use and functional recovery after stroke.
Methods
We retrospectively recruited 434 survivors of subacute stroke admitted for inpatient rehabilitation between 2000 and 2013 in our institution (107 with and 327 without GABA-AG use). We used multivariate regression to assess the association of GABA-AG use and successful functional recovery, defined as reaching, between admission and discharge, the minimal clinically important difference (MCID) of 22 points on the global Functional Independence Measure (FIM). Secondary analyses were the associations of GABA-AG with cognitive and motor FIM MCID and constant GABA-AG exposure (24h/24 GABA-AG) with global, cognitive and motor FIM MCID. A new estimation of the MCID was performed with the standard error of measurement.
Results
Reaching the global FIM MCID was associated with GABA-AG use (adjusted odds ratio [aOR] 0.54 [95% CI 0.31–0.91], P=0.02) as well as 24h/24 GABA-AG use (aOR 0.25 [0.08–0.83]; P=0.02). Furthermore, GABA-AG and 24h/24 GABA-AG use was inversely but not always significantly associated with reaching the cognitive FIM MCID (aOR 0.56, P=0.07; aOR 0.26, P=0.06, respectively) and motor FIM MCID (aOR 0.51, P=0.07; aOR 0.13, P=0.01, respectively). The estimated MCID was 19 for global FIM, 4 for cognitive FIM, and 16 for motor FIM.
Conclusions
GABA-AG use is associated with not reaching successful functional recovery during stroke rehabilitation. Randomised trials are needed to formally establish the potential deleterious effect of GABA-AG use on functional recovery. |
| Permalink : |
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in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 320-325
[article] GABAergic drug use and global, cognitive, and motor functional outcomes after stroke [texte imprimé] / A.J.-P. Schwitzguébel ; Charles Benaïm ; Stefano Carda ; [et al...] . - 2016 . - p. 320-325. Langues : Français ( fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 320-325
| Mots-clés : |
Recovery Rehabilitation Stroke GABA-A receptor agonists Benzodiazepines Minimal clinically important difference Functional independence measure |
| Résumé : |
Background
In animal models and healthy volunteers, the use of GABA A receptor agonists (GABA-AGs) seem deleterious for functional recovery. The agents are widely used for subacute stroke, but their effect on functional recovery remains unclear.
Objectives
We aimed to evaluate the association between GABA-AG use and functional recovery after stroke.
Methods
We retrospectively recruited 434 survivors of subacute stroke admitted for inpatient rehabilitation between 2000 and 2013 in our institution (107 with and 327 without GABA-AG use). We used multivariate regression to assess the association of GABA-AG use and successful functional recovery, defined as reaching, between admission and discharge, the minimal clinically important difference (MCID) of 22 points on the global Functional Independence Measure (FIM). Secondary analyses were the associations of GABA-AG with cognitive and motor FIM MCID and constant GABA-AG exposure (24h/24 GABA-AG) with global, cognitive and motor FIM MCID. A new estimation of the MCID was performed with the standard error of measurement.
Results
Reaching the global FIM MCID was associated with GABA-AG use (adjusted odds ratio [aOR] 0.54 [95% CI 0.31–0.91], P=0.02) as well as 24h/24 GABA-AG use (aOR 0.25 [0.08–0.83]; P=0.02). Furthermore, GABA-AG and 24h/24 GABA-AG use was inversely but not always significantly associated with reaching the cognitive FIM MCID (aOR 0.56, P=0.07; aOR 0.26, P=0.06, respectively) and motor FIM MCID (aOR 0.51, P=0.07; aOR 0.13, P=0.01, respectively). The estimated MCID was 19 for global FIM, 4 for cognitive FIM, and 16 for motor FIM.
Conclusions
GABA-AG use is associated with not reaching successful functional recovery during stroke rehabilitation. Randomised trials are needed to formally establish the potential deleterious effect of GABA-AG use on functional recovery. |
| Permalink : |
./index.php?lvl=notice_display&id=47166 |
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GABAergic drug use and global, cognitive, and motor functional outcomes after stroke in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)
