TY - JOUR
T1 - CHARACTERISTICS OF SUBACUTE STROKE PATIENTS WHO ACHIEVE EARLIER INDEPENDENCE IN REAL-LIFE WALKING PERFORMANCE DURING HOSPITALIZATION
AU - Kawakami, Kenji
AU - Tanabe, Shigeo
AU - Kinoshita, Daiki
AU - Kitabatake, Ryo
AU - Koshisaki, Hiroo
AU - Fujimura, Kenta
AU - Kanada, Yoshikiyo
AU - Sakurai, Hiroaki
N1 - Publisher Copyright:
© Author(s).
PY - 2025
Y1 - 2025
N2 - Objective: To identify factors associated with earlier independence in “real-life walking” during hospitalization in subacute stroke patients. Design: Retrospective cohort study. Subjects/Patients: Two hundred and six hemiplegic patients. Methods: Functional Independence Measure (FIM) walking items were measured biweekly from admission to discharge. Patients were grouped by achieving independent “real-life walking” (FIM-walking score ≥6). Time to independence, stratified by age, FIM motor score (FIM-M), FIM cognitive score (FIM-C), and Functional Ambulation Categories (FAC) scores were compared using Kaplan– Meier plots and log-rank tests. Hazard ratios were calculated via multivariable Cox proportional hazard models. Results: The median time to independence was 4 weeks, with significant differences (p < 0.05) by age, FIM-M, FIM-C, and FAC stratification. Age ≤64 years (hazard ratio 1.92, 95% confidence interval 1.21–3.06), FIM-C ≥25 (hazard ratio 2.42, 95% confidence interval 1.52–3.86), and FAC ≥3 (hazard ratio 1.98, 95% confidence interval 1.22– 3.21) significantly affected earlier walking independence (all p < 0.01). Impeding factors were FIM-M ≤38 (hazard ratio 0.23, 95% confidence interval 0.13–0.40; p < 0.01) and FAC = 0 (hazard ratio 0.184, 95% confidence interval 0.06–0.62; p < 0.01). Conclusion: Early improvement in “real-life walking” was associated with younger age, greater cognitive function, and greater “test-setting walking” ability on admission. Low activities of daily living independence and “test-setting walking” ability hindered early progress.
AB - Objective: To identify factors associated with earlier independence in “real-life walking” during hospitalization in subacute stroke patients. Design: Retrospective cohort study. Subjects/Patients: Two hundred and six hemiplegic patients. Methods: Functional Independence Measure (FIM) walking items were measured biweekly from admission to discharge. Patients were grouped by achieving independent “real-life walking” (FIM-walking score ≥6). Time to independence, stratified by age, FIM motor score (FIM-M), FIM cognitive score (FIM-C), and Functional Ambulation Categories (FAC) scores were compared using Kaplan– Meier plots and log-rank tests. Hazard ratios were calculated via multivariable Cox proportional hazard models. Results: The median time to independence was 4 weeks, with significant differences (p < 0.05) by age, FIM-M, FIM-C, and FAC stratification. Age ≤64 years (hazard ratio 1.92, 95% confidence interval 1.21–3.06), FIM-C ≥25 (hazard ratio 2.42, 95% confidence interval 1.52–3.86), and FAC ≥3 (hazard ratio 1.98, 95% confidence interval 1.22– 3.21) significantly affected earlier walking independence (all p < 0.01). Impeding factors were FIM-M ≤38 (hazard ratio 0.23, 95% confidence interval 0.13–0.40; p < 0.01) and FAC = 0 (hazard ratio 0.184, 95% confidence interval 0.06–0.62; p < 0.01). Conclusion: Early improvement in “real-life walking” was associated with younger age, greater cognitive function, and greater “test-setting walking” ability on admission. Low activities of daily living independence and “test-setting walking” ability hindered early progress.
KW - cerebrovascular disorders
KW - hemiplegia
KW - inpatient
KW - walking
UR - http://www.scopus.com/inward/record.url?scp=85215310644&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85215310644&partnerID=8YFLogxK
U2 - 10.2340/jrm.v57.41993
DO - 10.2340/jrm.v57.41993
M3 - Article
AN - SCOPUS:85215310644
SN - 1650-1977
VL - 57
JO - Journal of rehabilitation medicine
JF - Journal of rehabilitation medicine
M1 - jrm41993
ER -