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Early functional factors for predicting outcome of independence in daily living after stroke: a decision tree analysis.
Kim, Heegoo; Lee, Chanmi; Kim, Nayeong; Chung, Eunhye; Jeon, HyeongMin; Shin, Seyoung; Kim, MinYoung.
Affiliation
  • Kim H; Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Digital Therapeutics Research Team, CHA Future Medicine Research Institute, Seongnam, Republic of Korea.
  • Lee C; Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Digital Therapeutics Research Team, CHA Future Medicine Research Institute, Seongnam, Republic of Korea.
  • Kim N; Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Digital Therapeutics Research Team, CHA Future Medicine Research Institute, Seongnam, Republic of Korea.
  • Chung E; Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Digital Therapeutics Research Team, CHA Future Medicine Research Institute, Seongnam, Republic of Korea.
  • Jeon H; Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Digital Therapeutics Research Team, CHA Future Medicine Research Institute, Seongnam, Republic of Korea.
  • Shin S; Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Digital Therapeutics Research Team, CHA Future Medicine Research Institute, Seongnam, Republic of Korea; Rehabilitation and Regeneration Research Center, CHA University
  • Kim M; Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Digital Therapeutics Research Team, CHA Future Medicine Research Institute, Seongnam, Republic of Korea; Rehabilitation and Regeneration Research Center, CHA University
J Rehabil Med ; 56: jrm35095, 2024 May 07.
Article in En | MEDLINE | ID: mdl-38712968
ABSTRACT

OBJECTIVE:

This study aimed to investigate the predictive functional factors influencing the acquisition of basic activities of daily living performance abilities during the early stages of stroke rehabilitation using classification and regression analysis trees.

METHODS:

The clinical data of 289 stroke patients who underwent rehabilitation during hospitalization (164 males; mean age 62.2 ± 13.9 years) were retrospectively collected and analysed. The follow-up period between admission and discharge was approximately 6 weeks. Medical records, including demographic characteristics and various functional assessments with item scores, were extracted. The modified Barthel Index on discharge served as the target outcome for analysis. A "good outcome" was defined as a modified Barthel Index score ≥ 75 on discharge, while a modified Barthel Index score < 75 was classified as a "poor outcome."

RESULTS:

Two classification and regression analysis tree models were developed. The first model, predicting activities of daily living outcomes based on early motor functions, achieved an accuracy of 92.4%. Among patients with a "good outcome", 70.9% exhibited (i) ≥ 4 points in the "sitting-to-standing" category in the motor assessment scale and (ii) 32 points on the Berg Balance Scale score. The second model, predicting activities of daily living outcome based on early cognitive functions, achieved an accuracy of 82.7%. Within the "poor outcome" group, 52.2% had (i) ≤ 21 points in the "visuomotor organization" category of Lowenstein Occupational Therapy Cognitive Assessment, (ii) ≤ 1 point in the "time orientation" category of the Mini Mental State Examination.

CONCLUSION:

The ability to perform "sitting-to-standing" and visuomotor organization functions at the beginning of rehabilitation emerged as the most significant predictors for achieving successful basic activities of daily living on discharge after stroke.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Activities of Daily Living / Decision Trees / Stroke Rehabilitation Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: J Rehabil Med Journal subject: REABILITACAO Year: 2024 Document type: Article Country of publication: Sweden

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Activities of Daily Living / Decision Trees / Stroke Rehabilitation Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: J Rehabil Med Journal subject: REABILITACAO Year: 2024 Document type: Article Country of publication: Sweden