Factors associated with independent ambulation at 3 months after putaminal hemorrhage: an observational study

Noriko Ikeda1, Masaru Sakurai2, Emika Yamada2

  • 1Department of Rehabilitation, Kanazawa Medical University Hospital: 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan.

Insights

Predicting walking ability after putaminal hemorrhage is possible using clinical indicators. Severity of hemiplegia, cognitive function, and ventricular rupture are key predictors for ambulation prognosis.

Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Clinical Medicine

Background:

  • Putaminal hemorrhage is a severe type of stroke.
  • Predicting functional outcomes like ambulation is crucial for patient management.
  • Early identification of prognostic factors aids in rehabilitation planning.

Purpose of the Study:

  • To identify clinical indicators that predict ambulation at 3 months post-putaminal hemorrhage.
  • To evaluate the predictive value and optimal cut-off points for identified factors.

Main Methods:

  • Retrospective analysis of 84 inpatients with putaminal hemorrhage.
  • Evaluation of clinical data including consciousness, hemiplegia severity, cognitive function, and activities of daily living.
  • Logistic regression and receiver operating characteristic (ROC) curve analysis.

Main Results:

  • Ventricular rupture, hemiplegia severity (12-grade scale), and Functional Independence Measure (FIM) cognitive score independently predicted ambulation.
  • Hemiplegia severity was the strongest predictor (sensitivity 80.4%, specificity 100% at grade 6).
  • Grade 6 indicates the ability for coordinated hip joint movement.

Conclusions:

  • Clinical indicators including hemiplegia severity, FIM cognitive score, and ventricular rupture are significant predictors of 3-month ambulation post-putaminal hemorrhage.
  • Hip joint mobility is a critical factor for ambulation prognosis.
  • These findings can inform clinical decision-making and rehabilitation strategies.