Hiroshi Matsuo, MD, Shigeru Sonoda, MD, PhD, Shinichiro Maeshima, MD, PhD,
Makoto Watanabe, OTR, BA, Shou Sasaki, RPT, BA, Yuko Okuyama, RPT,
Hideto Okazaki, MD, PhD, Sayaka Okamoto, MD, PhD, Izumi Kondo, MD, PhD
Jpn J Compr Rehabil Sci 7: 119-129, 2016
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.
Key words: functional outcome, FIM (functional independence measure), ADL (activities of daily living), cerebral lesion, cerebrovascular disorders