The items and level contributing to improve in less than 50 motor functional independence measure upon admission in the stroke recovery rehabilitation ward

Abstract

[Purpose] To determine the motor Functional Independence Measure item and level that contribute to improvement in Functional Independence Measure gain in the recovery rehabilitation ward. [Participants and Methods] This study analyzed the data of 1,866 participants who were selected based on four criteria: age, number of days from onset to admission, length of hospital stay, and motor Functional Independence Measure upon admission. Moreover, all items examined were recorded. The participants were divided into two groups, the non-improving and improving group, based on a motor Functional Independence Measure gain of 22 points. The degree of contribution of each item was analyzed based on the median motor Functional Independence Measure. Logistic regression analysis was performed, with the two groups as dependent variables and the item with high contribution as independent variable; receiver operating characteristic analysis was performed. [Results] The items that highly contributed to motor Functional Independence Measure gain were bathing (level 3), dressing (lower body) (level 4), bladder management (level 5), and stair climbing (level 3). [Conclusion] The results of this study were suggested that the items that contribute to the improvement in motor Functional Independence Measure gain in stroke patients with a motor Functional Independence Measure of less than 50 were related to self-care and at least over moderate assistance.

Functional independence, clinical aspects, and sociodemographic factors in patients in the acute phase of stroke: an association analysis

“…The literature demonstrates a positive correlation between the degree of neurological impairment and the level of functional disability in patients in the chronic phase of stroke, indicating that greater neurological impairment corresponds to greater functional disability in this stage as well (8) . Thus, reliable prognoses must be made as early as the acute phase of stroke, as patients recover faster from deficits in this period, whereas 3 to 6 months after the event they reach a functional recovery plateau (8,9) . Therefore, it is important to take advantage of cerebral plasticity principles in the acute phase to obtain maximum functioning recovery (2) .…”

“…Hence, they ground short-and long-term rehabilitation strategies (8) . The acute phase is when patients recover the fastest from deficits (9) ; therefore, classifying this early their degree of independence increases their chances in intervention and rehabilitation towards better functional and quality-of-life prognosis.…”

Independência funcional, aspectos clínicos e fatores sociodemográficos em pacientes na fase aguda do Acidente Vascular Cerebral: uma análise de associação

“…A literatura evidencia que há correlação positiva entre o grau neurológico e o nível de incapacidade funcional de pacientes na fase crônica do AVC, indicando que maior comprometimento neurológico corresponde à maior incapacidade funcional também neste estágio (8) . Desta forma, a realização um de prognóstico confiável deve ser feito ainda na fase aguda do AVC, visto que neste período ocorre uma recuperação mais rápida dos déficits e que em torno de três a seis meses após o evento, os pacientes apresentam um platô na recuperação funcional (8,9) . Assim, deve-se aproveitar os princípios de plasticidade cerebral desde a fase aguda para a máxima recuperação da funcionalidade (2) .…”

“…Desta forma, considerando que é na fase aguda que ocorre uma recuperação mais rápida dos déficits (9) , a classificação do grau de independência do indivíduo, ainda nesta fase, possibilita maiores chances de intervenção e reabilitação e, consequentemente, um melhor prognóstico funcional e de qualidade de vida para o indivíduo.…”

Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury

“…In a study reviewing the records of over 1000 individuals with SCI from six different rehabilitation facilities, it was determined that, for people with paraplegia, the American Spinal Injury Association (ASIA) impairment scores of A, B, and C, being overweight or obese was associated with diminished motor functional independent measures (FIM) [23]. Motor categories in the FIM include self-care activities (dressing, bathing, grooming, toileting, and eating), transfer tasks, and locomotion tasks, including wheelchair propulsion [24]. Stenson et al also found that obese individuals with paraplegia had significantly lower FIM scores in self-care and mobility than non-obese individuals with paraplegia [25].…”