Interaction between Locomotion and Self-Care for Patients with Stroke in Severity Classification Based on the Motor Functional Independence Measure upon Admission to the Recovery Ward ()
Affiliation(s)
1Department of Physical Therapy, ASO Rehabilitation College, Higashi-Hie, Hakata-ku, Fukuoka-Shi, Fukuoka, Japan.
2Department of Rehabilitation Medicine, Saga University Hospital, Nabeshima, Saga-shi, Saga, Japan.
ABSTRACT
Background: A correlation between self-care and gait in stroke
patients has been shown. However, there are few reports suggesting an
interaction between self-care and gait. Purpose: To investigate the interaction between locomotion
and improvements in self-care. Participants and Methods: We retrospectively analyzed 3034 stroke patients
who were registered in the Japanese Rehabilitation Database. Using their data,
patients were classified into three groups (severe, moderate, slight) based on
the motor functional independence measure
upon admission, and data were modified as mean-centered values. We
performed a correlation analysis to evaluate the relationship among all the
collected data. Subsequently, a hierarchical multiple regression analysis was
performed to evaluate interaction using the self-care motor score from the
Functional Independent Measure (FIM) as the dependent variable. Model 1 used
two independent variables (National Institutes of Health Stroke Scale and cognitive
FIM score), model 2 used two independent variables (locomotion gain and gain of
an item with the strongest correlation coefficient to the de-pendent variable),
and model 3 used a mean-centering value, which was added to model 2. The simple
slope was used for further analysis. Results: Locomotion showed an interaction with self-care,
except in the slight group. The R2 changes in models 1 and 2 were
significant in the following: grooming, dressing lower body, and bladder
management in the severe group (p < 0.01), and only dressing upper body in
the moderate group (p < 0.01). Results of the simple slope analysis were
significant for grooming, bowel management, and dressing lower body in the
severe group and for dressing upper body in the moderate group. Conclusion: Locomotion demonstrated interaction with improving
self-care, mainly in the severe group. Therefore, for moderate and slight
cases, an intervention that not only involves locomotion training but also
focuses on improving activities of daily living should be considered.
Share and Cite:
Kimura, T. (2020) Interaction between Locomotion and Self-Care for Patients with Stroke in Severity Classification Based on the Motor Functional Independence Measure upon Admission to the Recovery Ward.
Open Journal of Therapy and Rehabilitation,
8, 164-182. doi:
10.4236/ojtr.2020.84015.
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