Mobility Assistive Device Utilization in a Prospective Study of Patients With First-Ever Stroke
Abstract
Jutai J, Coulson S, Teasell R, Bayley M, Garland J, Mayo N, Wood-Dauphinee S. Mobility assistive device utilization in a prospective study of patients with first-ever stroke.
Objective
To estimate the extent to which clinical and functional features of stroke were related to the use of mobility assistive technology devices.
Design
Longitudinal study of quality of life after stroke.
Setting
Hospitals, rehabilitation centers, and universities in Ontario and Quebec.
Participants
Subjects (N=316) with confirmed initial stroke were included in this analysis. Fifty-eight percent of the overall sample were men (n=184). The mean age of this sample at the time of the stroke ± standard deviation was 65.3±15.3 years (range, 19–96y). One hundred thirty-five patients received a mobility assistive device poststroke, and 181 did not.
Intervention
Assistive devices for mobility (canes, walkers, wheelchairs).
Main Outcome Measures
Assistive device use and mobility capacity.
Results
Mobility device nonusers were less physically disabled than device users on a variety of measures. Poor physical functioning but good cognition were reliably associated with mobility device use. Use of multiple mobility assistive devices was more often associated with poorer physical functioning than was single device use. For single device users, wheelchair use was predicted by cognition, functional independence, and stroke recovery. Cane users, compared with walker users, had better mobility and were less physically impaired by stroke.
Conclusions
Patients were well matched to device type based on their mobility capacity. The findings of this study suggest that assistive device prescription-outcome relationships in stroke can be effectively and meaningfully modeled.
aLawson Health Research Institute, St. Joseph’s Health Care London, Parkwood Hospital Site, London, ON, Canada
bDepartment of Physical Medicine and Rehabilitation, University of Western Ontario, London, ON, Canada
cSchool of Physical Therapy, University of Western Ontario, London, ON, Canada
dToronto Rehabilitation Institute & Department of Medicine, University of Toronto, Toronto, ON, Canada
eSchool of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
Reprint requests to Jeffrey W. Jutai, PhD, CPsych, Dept of Physical Medicine & Rehabilitation, Parkwood Hospital, Room B-3002a, 801 Commissioners Rd E, London, ON N6C 5J1, Canada
Supported by the Canadian Stroke Network (grant no. CSN-2000-011).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT