Original Article

Relationship between Functional Independence Measure (FIM) score on admission and influence of inhibitive factors in a comprehensive inpatient stroke rehabilitation ward

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

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