Sayaka Okamoto, MD, PhD, Shigeru Sonoda, MD, PhD, Makoto Watanabe, OTR,
Hideto Okazaki, MD, PhD, Kei Yagihashi, MD, Yuko Okuyama, PRT
Jpn J Compr Rehabil Sci 9: 59-65, 2018
Objective: Investigate how the influence of inhibitive
factors was changed by the status of activities of daily
living (ADL).
Methods: Subjects were 2,650 stroke hemiplegic
patients admitted to our comprehensive inpatient
rehabilitation wards. Decision tree analysis was
performed in which motor subscore of the Functional
Independence Measure (FIM-M) at discharge was set
as the target variable. Distribution of the verticality
item of the Stroke Impairment Assessment Set, age,
and the cognitive subscore of the FIM were calculated
for every score of the FIM-M on admission. The
FIM-M gain was compared by stratifying trunk
function, age, and FIM cognitive subscore with certain
ranges of the FIM-M on admission.
Results: The FIM-M at discharge and the FIM-M gain
were significantly low (p<0.05) in patients with
decreased trunk function and low ADL score on
admission. Both were significantly low (p<0.05) in
patients with relatively wide-ranged ADL scores in
elderly patients whose age was 68 years or older, and
also significantly low (p<0.05) in low cognitive
function patients who needed moderate or severe
assistance.
Conclusion: These results demonstrated that the
influence of inhibitive factors is not uniform but
instead differs according to degree of ADL level on
admission.
Key words: cerebrovascular disorders, rehabilitation, ADL, outcome prediction, inhibitive factors