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Relationship between behavioural observational rating scale of attention function and toileting ability in patients with acute stroke: A cross-sectional study.

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Updated: May 30, 2026

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Behavioral Problems and Self-Feeding Independence Among Patients With Acute Stroke: A Single-Center Study.

Takayuki Miyauchi1, Shotaro Sasaki2, Rumi Tanemura3

  • 1Takayuki Miyauchi, OT, Msc, is Assistant Professor, Department of Rehabilitation, Faculty of Medical Sciences, Shonan University of Medical Sciences, Kanagawa, Japan, and Graduate Student, Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan; takayuki.miyauchi@sums.ac.jp.

The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association
|July 26, 2024
PubMed
Summary

Stroke patients often struggle with self-feeding due to attention deficits. The Moss Attention Rating Scale (MARS) can identify these issues, guiding rehabilitation for improved eating independence.

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Occupational Therapy

Background:

  • Self-feeding independence is a key goal in acute stroke rehabilitation.
  • Attention deficits are common post-stroke but challenging to assess acutely.
  • Identifying behavioral issues in self-feeding is crucial for effective intervention.

Purpose of the Study:

  • To identify behavioral problems in acute stroke patients affecting self-feeding.
  • To utilize the Moss Attention Rating Scale (MARS) for assessing attention deficits in self-feeding.
  • To understand the impact of attention deficits on achieving eating independence.

Main Methods:

  • A cross-sectional, single-center study was conducted.
  • 96 acute stroke patients (median age 75.0 years) were evaluated a median of 3.0 days post-admission.
  • The primary outcome was the FIM® eating subscore, with the MARS score as the secondary outcome.

Main Results:

  • Significant differences in MARS scores (total, logit, and three-factor) were observed for self-feeding independence (p < .01).
  • The 'consistent or sustained' attention factor showed a large effect size (r = .83) on independence.
  • The MARS effectively identified behavioral problems linked to self-feeding dependence.

Conclusions:

  • Inability to sustain attention is a key behavioral problem in self-feeding dependence after stroke.
  • Sustained concentration during meals is essential for achieving eating independence.
  • Rehabilitation programs should focus on improving sustained attention for independent self-feeding.