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Profiles of functional outcomes in stroke rehabilitation for Chinese population: a cluster analysis
Stephanie Wai-Shan Louie1, Simon Kam-Man Wong, Cynthia Mei-Yuk Wong
1Occupational Therapy Department, Tai Po Hospital, Tai Po, Hong Kong. louie stephanie@yahoo.com.hk
Insights
This study identified four distinct functional profiles in stroke rehabilitation patients. Higher initial activities of daily living (ADL) performance, younger age, and no unilateral neglect correlate with better stroke recovery potential.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Gerontology
Background:
- Stroke rehabilitation programs aim to improve functional outcomes.
- Understanding patient heterogeneity is crucial for personalized rehabilitation.
- Longitudinal tracking of functional recovery reveals diverse trajectories.
Purpose of the Study:
- To identify distinct longitudinal activities of daily living (ADL) profiles in stroke survivors undergoing rehabilitation.
- To characterize the demographic, cognitive, and functional attributes associated with each identified profile.
- To investigate the relationship between baseline characteristics and recovery patterns in stroke patients.
Main Methods:
- Retrieved 496 stroke rehabilitation records from one year.
- Collected demographic data, Cantonese Mini-Mental State Examination, and line cancellation test scores.
- Utilized Chinese Modified Barthel Index (MBI-C) scores over four weeks for cluster analysis.
- Employed Repeated Measures ANOVA and One-way ANOVA to analyze functional profiles and group differences.
Main Results:
- Four distinct functional profiles emerged from cluster analysis.
- Profile 1 (oldest, lowest baseline MBI-C) showed late improvement; Profile 4 (youngest, highest baseline MBI-C) showed early rapid progress.
- Other profiles demonstrated improvement across all measurements with varying baseline MBI-C and increments.
- Significant differences in demographics, cognitive-perceptual, and speech functions were found among profiles.
Conclusions:
- Stroke survivors exhibit varied recovery potentials and functional trajectories.
- Higher initial ADL performance, younger age, and absence of unilateral neglect are associated with better functional recovery.
- These findings support tailored rehabilitation strategies based on identified patient profiles.
Abstract:
The objectives of study were to identify longitudinal ADL profiles and to investigate profiles characteristics of participants in stroke rehabilitation programme. 496 stroke rehabilitation records in one year were retrieved. Patients' demographics, admission scores of Cantonese version of Mini-mental State Examination and line cancellation test were retrieved. Chinese version of the Modified Barthel Index (MBI-C) records for the first four successive weeks were also obtained for cluster analysis. Four functional profiles were yielded after cluster analysis. Repeated measures ANOVA showed that Profile 1 (n = 168) with oldest age, lowest baseline MBI-C and line cancellation test scores had improvement only at the last two measurement points (p < 0.001). Profile 4 (n = 100) with youngest age and highest baseline MBI-C showed progress for the first two assessment points then slowing down progressively, while the other two profiles showed improvement on all measurement points (p < 0.001) but with different baseline MBI-C and increments. One-way ANOVA further revealed significant differences in demographics, cognitive-perceptual and receptive speech functions among the profiles. The present study revealed different recovery potential among people with stroke. The higher the initial ADL performance, younger age and the absence of unilateral neglect appeared to relate to better functional recovery.