Prediction of life-space mobility in patients with stroke 2 months after discharge from rehabilitation: a retrospective cohort study

Abstract

Purpose: To determine the predictors of life-space mobility among patients with stroke 2 months after discharge from a post-acute rehabilitation unit.

Materials and methods: The study population was 1023 patients discharged from a post-acute rehabilitation unit in Japan. We assessed the relationships between life-space mobility 2 months after discharge and age, sex, length of hospital stay, cognition and motor function (Functional Independence Measure), severity of hemiparesis, falls efficacy, physical function (Timed Up and Go (TUG) test), walking distance ability and social support from family and friends.

Results: Bivariate and multiple regression analyses showed that life-space mobility was predicted by sex, age, cognitive score at discharge, TUG score <15 s, length of hospital stay and falls efficacy at discharge. Taken together, these factors accounted for 54% of the variability in life-space mobility. A predictive formula was determined for clinical use.

Conclusions: The predictive formula provides an objective measure of life-space mobility for stroke patients after discharge. The clinical application of this formula could help health care professionals working in stroke rehabilitation to prepare patients for discharge and to set concrete goals for in-hospital rehabilitation to improve life-space mobility after discharge.

Implications for rehabilitation

• Accurate prediction of the prognosis for life-space mobility 2 months after discharge is useful in establishing clear goals for community-based rehabilitation.

• Long-term life-space mobility in the community is not only affected by physical function, but also by sex, age, cognitive ability and falls efficacy at discharge.

• Life-space mobility in female patients is affected by factors reflecting physical function, whereas life-space mobility in male patients is affected by both physical and cognitive function.

• Prediction of life-space mobility after stroke is important to determine unique mobility goals in rehabilitation and the required use of adaptive equipment after discharge (e.g., returning to work, engaging in a hobby or travelling beyond the immediate neighbourhood).

Keywords:

• Stroke
• mobility limitation
• community involvement
• cognition
• length of hospital stay
• social support

Acknowledgements

We would like to thank Dr. Yoshimi Suzukamo for her support and Editage (www.editage.jp) for English language editing. We also thank Jennifer Barrett, PhD, and Diane Williams, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript. A summary of this research was reported at the World Congress of the International Society of Physical Medicine and Rehabilitation (28 May to 2 June 2016) Kuala Lumpur, Malaysia.

Disclosure statement

The authors declare that there are no conflicts of interest for the present study.