Factors affecting the ADL of severe hemiplegic stroke patients at discharge from a convalescence rehabilitation hospital

Abstract

[Purpose] The objective of this study was to investigate whether it is possible to predict the activities of daily living (ADL) at discharge from the background factors and physical functions at admission of stroke patients with severe hemiplegia to a rehabilitation hospital. [Subjects and Methods] Among stroke patients admitted to a rehabilitation hospital, 62 first-time stroke patients with severe hemiplegia of the lower extremity (Brunnstrom Recovery Stage II or lower) at admission were included in this study. They were divided using the Barthel Index (BI) at discharge into two groups: the assisted independency group (n=45) and the dependency group (n=17). In a univariate analysis, background factors (age, sex, duration from onset to admission, paretic side, disease), and impairment factors (Modified National Institutes of Health Stroke Scale, Mini-Mental State examination, Trunk Control Test [TCT], muscle strength of the non-hemiplegic side leg) were compared between the two groups. In addition, for the variables showing significant differences, a discriminant analysis was conducted using ADL function at discharge as the dependent variable. [Results] Univariate analysis detected significant differences in age, time from stroke onset, trunk function, and knee extensor muscle strength on the non-hemiplegic side. Furthermore, discriminant analysis identified age, time from stroke onset, and knee extensor muscle strength on the non-hemiplegic side as significant factors. [Conclusion] The results of the present study indicate that the ADL function at discharge of stroke patients with severe hemiplegia admitted to a rehabilitation hospital may be predicted using the age, time from stroke onset, and knee extensor muscle strength on the non-hemiplegic side at admission.