Relationship of Unaffected Grip Strength and Trunk Function with Toileting Performance in Stroke Patients

Abstract

Toileting independence is important for patients to maintain self-esteem and to return home. Unaffected grip strength and trunk functions have been noted in earlier studies to be associated with toileting independence in stroke patients. The objective of this study was to explore appropriate indices and calculate cutoff values with regard to unaffected grip strength and trunk functions that could be completed in a short time for estimating toileting independence in stroke patients. Methods: The subjects were 37 stroke patients, each of whom scored at least 21 points in the Revised Hasegawa's Dementia Scale. The patients were divided into independent and non-independent toileting groups by FIM ® scores related to toiling items ("Toileting" and "Toilet transfer"). Logistic regression and receiver operating characteristic curve were used to elucidate items that showed an association with the presence or absence of toileting independence, and to calculate cutoff values of grip strength and trunk function from the Stroke Impairment Assessment Set as variables. Results: Grip strength was significantly associated with toileting independence. The cutoff value was 3 points (sensitivity, 74%; specificity, 71%; receiver operating characteristic area under the curve, 0.730). Discussion: Because grip strength can be quickly measured, calculated grip strength cutoff values can estimate a patient's ability for toileting independence. However, the cutoff value shown in the present study may be applicable to only patients with good trunk function.

Interaction between locomotion and three subcategories for patients with stroke demonstrating fewer than 37 points on the total functional independence measure upon admission to the recovery ward

“…Motor function, especially balance, has a more significant impact on dressing independence than cognitive function 29,30) . Toileting consists of three major actions; manipulating lower garments, cutting paper, and transferring to a toilet 31) . In patients with stroke, toileting has been usually proposed to be performed in a sitting position to avoid any possible downturn 32,33) .…”

“…Therefore, trunk function is related to balance in toileting and is important for the affected upper limb 34) . It was reported that TrA function influences the unaffected upper limb use with excretion 31,34) . Moreover, a past report stated that grip strength for handling lower body garments was improved by trunk function 31) .…”

“…Toileting consists of three major actions; manipulating lower garments, cutting paper, and transferring to a toilet 31 ) . In patients with stroke, toileting has been usually proposed to be performed in a sitting position to avoid any possible downturn 32 , 33 ) .…”