Physical functioning factors predicting a return home after stroke rehabilitation: A systematic review and meta-analysis

Abstract

Objectives This systematic review and meta-analysis sought to identify the physical functioning factors associated with home discharge after inpatient stroke rehabilitation. Data sources A search of PubMed, Embase, CINHAL, The Cochrane Library (Trials), Web of Science, and PEDro were conducted up until May 2023. Methods Two independent reviewers selected studies for population (patients with stroke), predictive factors (physical functioning), outcome (discharge destination), setting (inpatient rehabilitation), and study designs (observational and experimental studies). Predictive factors were identified among assessments of the “body function” and “activity” components of the International Classification of Functioning. Methodological quality was assessed with the Newcastle-Ottawa Scale. The findings used quantitative and narrative syntheses. Meta-analyses were performed with the inverse variance method and the random-effects model using included studies with sufficient data. Results Forty-five studies were included with 204,787 participants. Included studies assessed the association of independence in activities of daily living, walking, rolling, transferring, and balance on admission with a probability of returning home. Motor (odds ratio = 1.23, 95% confidence interval: 1.12–1.35, p < .001) and total (odds ratio = 1.34, 95% confidence interval: 1.14–1.57, p < .001) Functional Independence Measure scores on admission were significantly associated with home discharge in meta-analyses. Additionally, included studies showed that independence in motor activities, such as sitting, transferring, and walking, and scores above thresholds for the Functional Independence Measure and Berg Balance Scale on admission were associated with discharge destination. Conclusion This review showed that higher independence in activities of daily living on admission is associated with home discharge after inpatient stroke rehabilitation.

Factors Associated with Discharge Destination in Patients with Bone Metastases

“…Many studies have shown that ADL on admission and discharge were predictors of discharge destination of stroke patients [ 9 , 19 , 20 ]. The discharge destination predictors have been reported for several diseases, including spinal cord injury and post-proximal femoral fracture [ 21 , 22 ].…”

“…Furthermore, home-based supportive care improves the social and emotional QOL of patients with advanced cancer [ 8 ]. In stroke patients, a systematic review and meta-analysis reported that higher independence in ADLs on admission predicted a return to home [ 9 ]. Regarding cancer patients, performance status, age [ 10 ], and frailty [ 11 ] have been reported as factors associated with discharge home, but no definite conclusion has been reached.…”

Efficacy and safety of using a unilateral lower limb exoskeleton in neurorehabilitation: a randomized controlled trial

“…Physical therapists who were trained to perform standardized assessment procedures conducted all measurements in this study. The primary outcome of e cacy was the Berg Balance Scale (BBS) score [25,26]; the secondary outcome was the Functional Ambulation Category (FAC)…”

Impact of functional independence and sociodemographic factors on post-stroke discharge destination in a super-aged rural community in Japan

“…Typically, stroke survivors have hemiplegia and/or cognitive impairments that negatively affect functional independence in activities of daily living (ADL) 2 ) . Rehabilitation is often prescribed to these patients to recover functional independence 3 , 4 ) . One of the goals of stroke rehabilitation is home discharge 5 ) .…”