Article

OBJECTIVES: To (1) determine which clinical assessments at admission to an
inpatient rehabilitation facility (IRF) most simply predict discharge walking
ability, and (2) identify a clinical decision rule to differentiate household
versus community ambulators at discharge from an IRF.
DESIGN: Retrospective
cohort study. SETTING: IRF. PARTICIPANTS: Two samples of participants (n=110 and
159) admitted with stroke. INTERVENTIONS: A multiple regression determined which
variables obtained at admission (age, time from stroke to assessment, Motricity
Index, somatosensation, Modified Ashworth Scale, FIM, Berg Balance Scale, 10-m
walk speed) could most simply predict discharge walking ability (10-m walk
speed). A logistic regression determined the likelihood of a participant
achieving household (<0.4m/s) versus community (>/=0.4-0.8m/s; >0.8m/s)
ambulation at the time of discharge. Validity of the results was evaluated on a
second sample of participants. MAIN OUTCOME MEASURE: Discharge 10-m walk speed.
RESULTS: Admission Berg Balance Scale and FIM walk item scores explained most of
the variance in discharge walk speed. The odds ratio of achieving only household
ambulation at discharge was 20 (95% confidence interval [CI], 6-63) for sample 1
and 32 (95% CI, 10-96) for sample 2 when the combination of having a Berg Balance
Scale score of </=20 and a FIM walk item score of 1 or 2 was present.
CONCLUSIONS: A Berg Balance Scale score of </=20 and a FIM walk item score of 1
or 2 at admission indicates that a person with stroke is highly likely to only
achieve household ambulation speeds at discharge from an IRF.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS