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Early multidimensional mobility assessments for discriminating discharge-level ambulation and functional independence
Seung Heun An1, Eun Joo Kim2, Jun Min Lee3
1Department of Gait Lab, National Rehabilitation Center, Seoul, South Korea.
Objective:
To examine whether early multidimensional mobility assessments discriminate independent ambulation and functional independence on discharge in subacute stroke inpatients with supervised walking ability.
Design:
Retrospective cohort study.
Subjects/Patients:
Fifty subacute stroke inpatients (≤ 5 months post-stroke).
Methods:
Independent ambulation and functional independence were defined as Functional Ambulation Category ≥ 4 and Modified Barthel Index 75 on discharge, respectively. Discriminative ability of admission assessments was evaluated using univariate binary logistic regression and receiver operating characteristic curve analysis.
Results:
The Berg Balance Scale and the modified Four Square Step Test demonstrated the highest discriminative performance. For independent ambulation, the Berg Balance Scale (≥ 40.5) yielded an area under the curve of 0.74 (95% confidence interval: 0.60-0.88) with 82% accuracy, and the modified Four Square Step Test (≤ 31.52 s) yielded an area under the curve of 0.78 (0.64-0.91) with 80% accuracy. For functional independence, the Berg Balance Scale (≥ 42.5) yielded an area under the curve of 0.74 (0.60-0.88) with 74% accuracy, and the modified Four Square Step Test (≤ 32.88 s) yielded an area under the curve of 0.71 (0.57-0.86) with 70% accuracy.
Conclusion:
Early balance and multidirectional stepping performance may be useful for screening to support goal-setting and discharge planning.
