Characteristics of subacute stroke patients who achieve earlier independence in real-life walking performance during hospitalization
Objective: To identify factors associated with earlier independence in “real-life walking” during hospitalization in subacute stroke patients. Design: Retrospective cohort study. Subjects/Patients: Two hundred and six hemiplegic patients. Methods: Functional Independence Measure (FIM) walking ite...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Medical Journals Sweden
2025-01-01
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| Series: | Journal of Rehabilitation Medicine |
| Subjects: | |
| Online Access: | https://medicaljournalssweden.se/jrm/article/view/41993 |
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| Summary: | Objective: To identify factors associated with earlier independence in “real-life walking” during hospitalization in subacute stroke patients.
Design: Retrospective cohort study.
Subjects/Patients: Two hundred and six hemiplegic patients.
Methods: Functional Independence Measure (FIM) walking items were measured biweekly from admission to discharge. Patients were grouped by achieving independent “real-life walking” (FIM-walking score ≥6). Time to independence, stratified by age, FIM motor score (FIM-M), FIM cognitive score (FIM-C), and Functional Ambulation Categories (FAC) scores were compared using Kaplan–
Meier plots and log-rank tests. Hazard ratios were calculated via multivariable Cox proportional hazard models.
Results: The median time to independence was 4 weeks, with significant differences (p < 0.05) by age, FIM-M, FIM-C, and FAC stratification. Age ≤64 years (hazard ratio 1.92, 95% confidence interval 1.21–3.06), FIM-C ≥25 (hazard ratio 2.42, 95% confidence interval 1.52–3.86), and FAC ≥3 (hazard ratio 1.98, 95% confidence interval 1.22–3.21) significantly affected earlier walking independence (all p < 0.01). Impeding factors were FIM-M ≤38 (hazard ratio 0.23, 95% confidence interval 0.13–0.40; p < 0.01) and FAC = 0 (hazard ratio 0.184, 95% confidence interval 0.06–0.62; p < 0.01).
Conclusion: Early improvement in “real-life walking” was associated with younger age, greater cognitive function, and greater “test-setting walking” ability on admission. Low activities of daily living independence and “test-setting walking” ability hindered early progress.
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| ISSN: | 1651-2081 |