Age and Functional Outcomes Post-Neurologic Insult in Patients Attending Inpatient Rehabilitation

Introduction Neurologic insults such as strokes and traumatic brain injuries (TBI) affect over 1 million Americans every year. The lack of current knowledge informing accurate prognoses causes victims and their loved ones distress, and is a focus of much research. The purpose of this study was to determine whether patient age at time of insult could predict change in functional outcomes during inpatient rehabilitation. Methods Subjects were patients of an inpatient rehabilitation facility (IRF) post-stroke or TBI. The Functional Independence Measure (FIM) assessed functional independence and cognitive status at admission and discharge from the IRF. The Montebello Rehabilitation Factor Score (MRFS) incorporated admission and discharge FIM scores to calculate each subject’s change in cognitive and motor functional independence. Descriptive statistics and linear regression analyses were calculated using SPSS v24. Results Data from twenty subjects were included in the study (66.5 ± 18.0 years; n=7 female). The overall regression model was trending towards statistical significance, where lower age predicted cognitive MRFS (F = 3.714, p = 0.070, β = -0.414, R2 = 0.171) and motor MRFS (F = 25.008, p \u3c 0.001 , β = -0.763, R2 = 0.581) at discharge from the IRF. Conclusions Our findings are consistent with previous research demonstrating that neurologic insult at a younger age is correlated with better functional outcomes from that incident. Providers and therapists should use this information in educating patients and their support network about the patient’s possible prognosis

Effect of Sleep Deprivation and Sleep Recovery on Heart Rate and Heart Rate Variability in Males Versus Females

Introduction Elevated heart rate (HR) and low HR variability (HRV) are indicators of increased sympathetic tone and cardiovascular risk. Here, we assess the effect of one night of sleep deprivation and a subsequent night of recovery sleep on HR and HRV in healthy males versus females. Methods Fifty-nine subjects (29.5±8.5y, n=35 female) completed a 4-day/3-night laboratory study. Subjects had a baseline sleep opportunity (22:00–08:00), followed by 38h of sleep deprivation, and a recovery sleep opportunity (22:00–08:00). EKG was monitored via Holter monitors to measure HR and the pNN50 and rMMSD variables of HRV. Time points used for analyses included 09:00–09:20 during a seated task on each day: baseline (1h after waking), sleep deprivation (25h after waking), and recovery (1h after waking). Results There was no significant interaction of day by sex in HR, pNN50, or rMMSD (p\u3e0.05). There was, however, a significant effect of day (p Conclusion The effect of sleep deprivation on HR and HRV indicates a decrease in sympathetic activity, in-line with previous research reporting inhibition of the brain’s arousal centers as a consequence of increasing time awake. Notably, HR and HRV returned to baseline levels following a night of recovery sleep. Despite higher HR and lower HRV in females versus males at baseline, both sexes showed a similar cardiac autonomic response to sleep deprivatio