RETURN TO HIGH FUNCTIONAL LEVEL POST STROKE USING MULTIDISCIPLINARY CLINICAL REHABILITATION
Bibliographic record
Abstract
Barathi Sreenivasan1, MD, FRCPC, CSCN (EMG) Diplomate, Merav Cohen1, PT, Amy Szeto1, OT, Darinka Jokanovic1, RN, Karin Abel 1 ,SLP, and Sandy Cayne1, SW, RSW. 1. University of Toronto, Sunnybrook Hospital, Toronto, Canada Background: A 51 year old male presented with left lower extremity weakness and a flaccid left upper extremity, dysarthria, dysphonia, mild left inattention and hemisensory impairment. He was diagnosed with right Middle Cerebral Artery territory infarct secondary to right Internal Carotid Artery territory dissection. Patient participated in multidisciplinary rehabilitation with the goal of returning to previously high level of function.Treatment : Multidisciplinary rehabilitation including Occupational Therapy to address Activities of Daily Living (ADL), left upper extremity strength motor control and planning, transfer training and left inattention. Physiotherapy addressed lower extremity strengthening, gait training, motor control, scapular mobility and stretching. Speech language pathology addressed issues of dysarthria and dysphonia. Social work provided counselling regarding return to work and psychosocial adjustment. Nursing monitored patientu2019s blood pressure, counselled regarding medications and assisted physician in clinic. Physiatrist provided regular care regarding stroke rehabilitation issues and treated spasticity initially conservatively and subsequently with botulinum toxin injections to left upper and lower extremity. Pacing techniques and energy conservation were addressed by all team members.Results: Patient able to ambulate without ambulatory aids, and lower extremity tone normalized. Upper extremity function and spasticity improved to point where only very small doses of Botulinum toxin required to maintain patientu2019s finger flexibility for two hand typing. Patient resumed pre-stroke engagement in biking and weight training, and full time work as a high functioning management executive. Conclusion: Multidisciplinary clinical rehabilitation using a team approach can assist patients with significant impairments in returning to premorbid high levels of function.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".