Abstract
Matsuo H, Sonoda S, Maeshima S, Watanabe M, Sasaki S, Okuyama Y, Okazaki H, Okamoto S, Kondo I. Contribution of physical impairment or imaging findings in the prediction of ADL outcome in stroke patients with middle cerebral artery infarction. Jpn J Compr Rehabil Sci 2016; 7: 119-129.
Objective: Effective rehabilitation can be realized through improved prediction accuracy of activities of daily living (ADL) outcomes in stroke patients after cerebral infarction. We investigated whether physical impairment and imaging findings contributed to improved prediction accuracy of ADL outcomes in stroke patients with a first time unilateral infarction in the middle cerebral artery.
Methods: The study included a total of 331 patients with diffusion-weighted magnetic resonance images from an acute-care hospital, who were admitted to our Kaifukuki Rehabilitation Wards. Admission Functional Independence Measure (FIM) motor (FIM-M) score, admission FIM cognitive score, age, days until admission to our hospital, Stroke Impairment Assessment Set (SIAS) (motor function, trunk function, unilateral spatial neglect, and lower limb position), type of cerebral infarction, and presence of lesions were set as independent variables. Discharge FIM-M score and FIM-M gain were designated as dependent variables. Multiple regression analysis, logistic regression analysis, and decision tree analysis were performed. In addition, independent variables that significantly contributed to improved prediction accuracy of ADL outcomes were clarified by stratifying patients and inserting/deleting independent variables.
Results: Trunk function and presence of lesions contributed to improved accuracy in predicting FIM-M gain in patients with low admission FIM-M scores.
Conclusion: Using physical impairment and image findings in addition to the admission ADL in patients with first time unilateral infarctions in the middle cerebral artery after stratification was useful in predicting the discharge ADL.
