A path analysis model for grooming performance in stroke patients

Abstract

Purpose: The aim of this study was to clarify the relationships between various types of functions and grooming performance and describe their hierarchical structure in survivors of stroke.

Method: This was a retrospective observational study on 75 individuals with first stroke. A hypothetical path model, created based on previous studies, was examined for goodness of fit between the data and the model using path analysis. We hypothesized that in survivors of stroke, grooming performance is influenced by age, motor and sensory functions of the affected limbs, trunk function, grip and knee extensor strength, visuospatial perception, intellectual function, motivation, affected and unaffected upper limb function, and balance.

Results: A revised path model was created that achieved goodness-of-fit index criteria. Balance, affected and unaffected upper limb function, and motivation were found to have a direct effect and balance and unaffected upper limb function were found to have especially stronger effect on grooming performance. The order of the standardized total effects of each function was as follows: balance, unaffected upper limb function, motivation, and affected lower limb function.

Conclusions: Our results suggest that interventions targeting balance and unaffected upper limb function could be effective in rehabilitation to improve grooming performance in survivors of stroke.

Implications for rehabilitation

• Balance and unaffected upper limb function have a strong effect on grooming independence in survivors of stroke.

• Balance is most influenced by affected lower limb function, and unaffected upper limb function is equally influenced by balance, visuospatial perception, and grip strength.

• Interventions targeting balance and unaffected upper limb function can improve grooming performance in survivors of stroke.

Keywords:

• Activities of daily living
• rehabilitation
• hierarchy
• balance
• upper limb function
• motivation

Acknowledgements

The use of the FIM^® instrument to collect data for this research study was authorized and conducted in accordance with the term of a special purpose license granted to the licensee by the Uniform Data System for Medical Rehabilitation (UDSMR). Licensee has not been trained by UDSMR in the use of the FIM^® instrument, and the patient data collected during the course of this research study have not been submitted to or processed by UDSMR. No implication is intended that such data have been or will be subjected to UDSMR’s standard data processing procedures or that it is otherwise comparable to data processed by UDSMR.

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This work was supported by a grant from the Japan Society for the Promotion of Science KAKENHI [grant No. 16K20768].