Abstract
Objective
To investigate whether self-exercise programs for patients after stroke contribute
to improved activities of daily living (ADL) at hospital discharge.
Design
Retrospective, observational, propensity score (PS)–matched case-control study.
Setting
General hospitals.
Participants
Participants included patients after stroke (N=1560) hospitalized between January
3, 2006, and December 26, 2012, satisfying the following criteria: (1) data on age,
sex, duration from stroke to hospital admission, length of stay, FIM score, modified
Rankin Scale (mRS) score, Glasgow Coma Scale score, Japan Stroke Scale score, and
self-exercise program participation were available; and (2) admitted within 7 days
after stroke onset, length of stay was between 7 and 60 days, prestroke mRS score
was ≤2, and not discharged because of FIM or mRS exacerbation. A total of 780 PS-matched
pairs were selected for each of the self-exercise program and no–self-exercise program
groups.
Intervention
Self-exercise program participation.
Main Outcome Measures
At discharge, FIM motor score, FIM cognitive score, FIM motor score gain (discharge
value − admission value), FIM motor score gain rate (gain/length of stay), a binary
variable divided by the median FIM motor score gain rate (high efficiency or no–high
efficiency), and mRS score.
Results
Patients were classified into a self-exercise program (n=780) or a no–self-exercise
program (n=780) group. After matching, there were no significant between-group differences,
except motor system variables. The receiver operating characteristic curve for PS
had an area under the curve value of .71 with a 95% confidence interval of .68 to
.73, and the model was believed to have a relatively favorable fit. A logistic regression
analysis of PS-matched pairs suggested that the self-exercise program was effective,
with an overall odds ratio for ADL (high efficiency or no–high efficiency) of 2.2
(95% confidence ratio, 1.75–2.70).
Conclusions
SEPs may contribute to improving ADL.
Keywords
List of abbreviations:
ADL (activities of daily living), GCS (Glasgow Coma Scale), JSS (Japan Stroke Scale), mRS (modified Rankin Scale), PS (propensity score), RCT (randomized controlled trial)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 12, 2016
Footnotes
Supported by Japan Society for the Promotion of Science Grants-in-Aid for Scientific Research (grant nos. 25350640 and 25350659).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
