Vitality index is a predictor of the improvement in the functional independence measure score in subacute stroke patients with cognitive impairment

ABSTRACT

Objectives

To investigate the effect of motivation on improvements in the Functional Independence Measure (FIM) scores in subacute stroke patients with cognitive impairment.

Methods

This retrospective cohort study included 358 consecutive subacute stroke patients with first-ever stroke and Mini-Mental State Examination score ≤23 at admission. We determined motivation and rehabilitation outcome using the vitality index and FIM-motor gain, respectively. Stepwise multiple regression analysis was performed to identify the factors at admission related to FIM-motor gain.

Results

Of 80 participants enrolled in this study (mean age: 74.2 ± 11.3 years). The median (interquartile range) vitality index at admission and FIM-motor gain were 7 (4) and 23 (22) points, respectively. Stepwise multiple regression analysis revealed that age (B, −0.43; 95% confidence interval [CI], −0.65–(−0.21); β, −0.31; P <.001), duration from stroke onset to admission (B, −0.18; 95% CI, −0.33–(−0.04); β, −0.20; P =.014) and Stroke Impairment Assessment Set-motor function (B, 1.27; 95% CI, 0.92–1.61; β, 0.78; P <.001), FIM-motor (B, −0.80; 95% CI, −1.01–(−0.60); β, −0.95; P <.001), and vitality index (B, 3.79; 95% CI, 2.37–5.21; β, 0.50; P <.001) scores at admission were significantly associated with the FIM-motor gain.

Discussion

The vitality index was significantly associated with FIM improvement in subacute stroke patients with cognitive impairment.

KEYWORDS:

• Subacute stroke
• motivation
• cognitive impairment
• functional Independence Measure
• mini-Mental State Examination

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical consideration

This study was conducted in accordance with the Declaration of Helsinki; this study was reviewed and approved by the Ethics Committee of Tokyo Bay Rehabilitation Hospital (#148).