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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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2025-01-01
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| Series: | Journal of Rehabilitation Medicine |
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| Online Access: | https://medicaljournalssweden.se/jrm/article/view/41993 |
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| author | Kenji Kawakami Shigeo Tanabe Daiki Kinoshita Ryo Kitabatake Hiroo Koshisaki Kenta Fujimura Yoshikiyo Kanada Hiroaki Sakurai |
| author_facet | Kenji Kawakami Shigeo Tanabe Daiki Kinoshita Ryo Kitabatake Hiroo Koshisaki Kenta Fujimura Yoshikiyo Kanada Hiroaki Sakurai |
| author_sort | Kenji Kawakami |
| collection | DOAJ |
| description | 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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| format | Article |
| id | doaj-art-a3046c9901c0418a8000e4017acbaeb9 |
| institution | Kabale University |
| issn | 1651-2081 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Rehabilitation Medicine |
| spelling | doaj-art-a3046c9901c0418a8000e4017acbaeb92025-01-03T09:19:26ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812025-01-015710.2340/jrm.v57.41993Characteristics of subacute stroke patients who achieve earlier independence in real-life walking performance during hospitalizationKenji Kawakami0https://orcid.org/0009-0005-2953-8554Shigeo Tanabe1Daiki Kinoshita2Ryo Kitabatake3Hiroo Koshisaki4https://orcid.org/0000-0001-8742-070XKenta Fujimura5https://orcid.org/0000-0003-3657-4308Yoshikiyo Kanada6Hiroaki Sakurai7Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake-shi, Aichi, Japan; Graduate School of Health Sciences, Fujita Health University, Aichi, Japan; Department of Rehabilitation, Kyoto Rehabilitation Hospital, Kyoto-shi, Kyoto, JapanFaculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake-shi, Aichi, Japan; Graduate School of Health Sciences, Fujita Health University, Aichi, JapanDepartment of Rehabilitation, Kyoto Rehabilitation Hospital, Kyoto-shi, Kyoto, JapanDepartment of Rehabilitation, Kyoto Rehabilitation Hospital, Kyoto-shi, Kyoto, JapanDepartment of Rehabilitation, Nanto Municipal Hospital, Toyama, JapanFaculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake-shi, Aichi, Japan; Graduate School of Health Sciences, Fujita Health University, Aichi, JapanFaculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake-shi, Aichi, Japan; Graduate School of Health Sciences, Fujita Health University, Aichi, JapanFaculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake-shi, Aichi, Japan; Graduate School of Health Sciences, Fujita Health University, Aichi, JapanObjective: 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. https://medicaljournalssweden.se/jrm/article/view/41993cerebrovascular disordershemiplegiainpatientwalking |
| spellingShingle | Kenji Kawakami Shigeo Tanabe Daiki Kinoshita Ryo Kitabatake Hiroo Koshisaki Kenta Fujimura Yoshikiyo Kanada Hiroaki Sakurai Characteristics of subacute stroke patients who achieve earlier independence in real-life walking performance during hospitalization Journal of Rehabilitation Medicine cerebrovascular disorders hemiplegia inpatient walking |
| title | Characteristics of subacute stroke patients who achieve earlier independence in real-life walking performance during hospitalization |
| title_full | Characteristics of subacute stroke patients who achieve earlier independence in real-life walking performance during hospitalization |
| title_fullStr | Characteristics of subacute stroke patients who achieve earlier independence in real-life walking performance during hospitalization |
| title_full_unstemmed | Characteristics of subacute stroke patients who achieve earlier independence in real-life walking performance during hospitalization |
| title_short | Characteristics of subacute stroke patients who achieve earlier independence in real-life walking performance during hospitalization |
| title_sort | characteristics of subacute stroke patients who achieve earlier independence in real life walking performance during hospitalization |
| topic | cerebrovascular disorders hemiplegia inpatient walking |
| url | https://medicaljournalssweden.se/jrm/article/view/41993 |
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