Article

PURPOSE: To determine the prognostic value of single items of the Barthel Index
(BI) at discharge from rehabilitation, in predicting independence in personal
activities of daily living (ADL) (BI score >/= 95/100) at five years after
stroke. METHOD: People with stroke were recruited consecutively from four
European rehabilitation centres. BI was assessed on discharge and at five years
after stroke. Stepwise multivariate logistic regression analysis was used to
determine independent predictors of BI score >/= 95/100 at five years after
stroke. Thereupon, percentage chance of reaching BI >/= 95/100 at five years
after stroke was calculated. RESULTS: Data were available for 153 patients.
Independence in dressing (odds ratio (OR)=5.22, 95% confidence interval
(CI)=1.85-14.76, p=0.002) and bathing (OR=8.10, 95% CI=3.40-19.32, p<0.0001) were
independent predictors. Independence in both items resulted in 74.1% (57.6-85.8)
chance of reaching BI >/= 95/100 at five years after stroke. Dependence in both
items resulted in 6.3% (5.1-7.9) chance. Independence in bathing, but dependence
in dressing resulted in 35.4% (30.7-40.4) chance whereas the opposite resulted in
26.1% (20.7-32.3) chance. CONCLUSION: Simple assessment of dressing and bathing
on discharge from rehabilitation enables therapeutic staff to predict prognosis
for long-term independence in personal ADL. This method can be used for early
identification of persons with stroke who need intensive follow-up. Implications
for Rehabilitation (In)dependence for dressing and bathing at discharge from a
rehabilitation centre are significant factors in the prediction of (in)dependence
in personal ADL at five years after stroke. This predictive tool can be used for
targeting inpatient stroke rehabilitation and early identification of those
patients who need intensive follow-up.

Langue : ANGLAIS