Interaction between locomotion and three subcategories for patients with stroke demonstrating fewer than 37 points on the total functional independence measure upon admission to the recovery ward

Abstract

[Purpose] To investigate the interaction between locomotion and improvements in performing self-care. [Participants and Methods] We retrospectively analyzed 930 patients with stroke who were registered in the Japanese Rehabilitation Database. We performed a correlation analysis to evaluate the relationships among all the collected data. Then, hierarchical multiple regression analysis was performed using the self-care motor score of the Functional Independent Measure (FIM) as the dependent variable. “Model 1” used two independent variables (National Institute of Health Stroke and Rankin Scale), “model 2” used two independent variables (locomotion gain and gain of an item with the closest coefficient correlation added to model 1), and “model 3” used a mean-centering value, which was added to model 2. R² values were calculated using a simple slope analysis. [Results] Locomotion showed an interaction with three self-care activities. The R² changes in models 1 and 2 (ΔR²) were significant for dressing upper body (ΔR²=0.001), bowel management (ΔR²=0.006), and toileting (ΔR²=0.006). The results of the simple slope analysis were significant. [Conclusion] Locomotion demonstrated an interaction with various activities for improving self-care. There were varying degrees of improvement in self-care despite a uniform improvement in the degree of locomotion. Therefore, locomotion interaction should be considered for each intervention that targets activities of daily living.