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Predictive factors for ambulation in stroke patients in the rehabilitation setting: a multivariate analysis
Stefano Masiero1, Renato Avesani, Mario Armani
1Department of Rehabilitation Medicine, Unit of Rehabilitation, University of Padova, School of Medicine, Padova, Italy. stef.masiero@unipd.it
Object:
The purpose of this study was to investigate predictive factors for ambulatory recovery in stroke patients undergoing rehabilitation.
Methods:
One hundred and eight-five first-stroke hemiplegics, admitted to an inpatient stroke rehabilitation program, were consecutively recruited to the study. Functional status at admission and discharge was evaluated by the Functional Independence Measure (FIM) and its motor component (motFIM), the upper and lower Motricity Index (upMI and lowMI), and the Trunk Control Test (TCT). The outcome variable was the Functional Ambulation Classification (FAC) score, assessed at discharge from rehabilitation. Multivariate analysis was used to assess the relationships between functional outcome (FAC), and the predictive variables.
Results:
Up- and lowMI, FIM and motFIM, TCT and age at admission were significantly related to ambulatory recovery at discharge. Logistic regression analysis showed that the independent variables related to FAC were age, TCT and FIM: the model correctly allocated 86 out of 100 cases in the construction set and 76% of cases in the validation set. The ROC curve with logistic function output as the risk factor afforded very good accuracy (ROC area=0.94), sensitivity=86.5% and specificity=85.4%.
Conclusions:
Our results show that age and level of motor and functional impairment measured at baseline are significant predictors of ambulatory outcome. These findings promise to be of interest in goal optimization in the rehabilitation setting.
