Association between Days to Achieve Assisted Toileting and Physical and Cognitive Dysfunction in Stroke Patients with Hemiplegia and Pusher Phenomenon

Abstract

[Purpose] To investigate factors associated with improvement in toileting assistance of hemiplegic stroke patients with pusher phenomenon. [Participants and Methods] Nine stroke patients with pusher phenomenon were included. A standing training program with graded difficulty was implemented. The number of days required to achieve toileting with two-person and one-person assistance was calculated. Associations among physical function, higher brain dysfunction, and Functional Independence Measure (FIM) scores were assessed using Spearman’s rank correlation coefficient. [Results] All patients achieved two-person assistance (median: 7 days), and six patients achieved one-person assistance (median: 13 days). The number of days required to achieve two-person assistance was significantly correlated with pusher severity and FIM scores. The number of days required to achieve one-person assistance was also significantly correlated with lower extremity motor function assessed by the Stroke Impairment Assessment Set (SIAS). [Conclusion] These findings suggest that factors associated with improvement in toileting assistance may differ according to the stage of recovery.