Abstract
Objective
To demonstrate a proof-of-concept for prognostic models of post-stroke recovery on
activity level outcomes.
Design
Longitudinal cohort with repeated measures from acute care, inpatient rehabilitation,
and post-discharge follow-up to 6 months post-stroke.
Setting
Enrollment from a single Midwest USA inpatient rehabilitation facility with community
follow-up.
Participants
115 persons recovering from stroke admitted to an acute rehabilitation facility
Interventions
Not applicable
Main Outcome Measure(s)
Activity Measure for Post-Acute Care (AM-PAC) Basic Mobility and Daily Activities
domains administered as 6 Clicks and patient-reported short forms.
Results
The final Basic Mobility model defined a group-averaged trajectory rising from a baseline
(pseudo-intercept) T-score of 35.5 (p<.001) to a plateau (asymptote) T-score of 56.4
points (p<.001) at a negative exponential rate of -1.49 (p<.001). Individual baseline
scores varied by age, acute care tissue plasminogen activator, and acute care length
of stay. Individual plateau scores varied by walking speed, acute care tissue plasminogen
activator, and lower extremity Motricity Index scores. The final Daily Activities
model defined a group-averaged trajectory rising from a baseline T-score of 24.5 (p<.001)
to a plateau T-score of 41.3 points (p<.001) at a negative exponential rate of -1.75
(p<.001). Individual baseline scores varied by acute care length of stay, and plateau
scores varied by self-care, upper extremity Motricity Index, and Berg Balance Scale
scores.
Conclusions
As a proof-of-concept, individual activity-level recovery can be predicted as patient-level
trajectories generated from EMR data, but models require attention to completeness
and accuracy of data elements collected on a fully representative patient sample.
Keywords
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Article info
Publication history
Accepted:
August 24,
2022
Received in revised form:
August 12,
2022
Received:
April 11,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 by the American Congress of Rehabilitation Medicine.
