Validity of the stroke upper limb capacity scale in acute inpatient stroke rehabilitation

 

'Assessments' DO NOTHING unless you map EXACT RECOVERY PROTOCOLS TO THEM! This was absolutely useless for getting survivors recovered! Stroke research is to get survivors recovered; you'll want recovery when you are the 1 in 4 per WHO that has a stroke! Just maybe you want to do the proper research now!

WITH NO LEADERSHIP IN STROKE NOTHING EVER GETS DONE PROPERLY!

Validity of the stroke upper limb capacity scale in acute inpatient stroke rehabilitation

O’Dell, Michael Wayne^a,b; Ghafari, George^a; Campo, Marc^a,c; Jaywant, Abhishek^a,d; Tufaro, Daniel^b,e; Toglia, Joan^a,c

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International Journal of Rehabilitation Research 48(4):p 217-224, December 2025. | DOI: 10.1097/MRR.0000000000000682

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The aim of this study was to determine the validity of the Stroke Upper Limb Capacity Scale (SULCS) and its three hand categories in an acute inpatient stroke rehabilitation setting. We included 312 persons, about 10 days poststroke, with a mean National Institutes of Health Stroke Score (NIHSS) of 7.3. Participants were also assessed on the functional independence measure (FIM), Upper Extremity–Motricity Index (UE-MI), modified Charlson Comorbidity Index, and proportion of home discharges. Spearmans rho between total SULCS and FIM-self-care score and UE-MI at admission were strong at 0.72 and 0.82, respectively. Correlations were stronger between SULCS and individual FIM items of eating, grooming, and bathing [rho= 0.52–0.57, that is, ‘more’ activity of daily living (ADL)-like items] rather than walking, bowel, and expression (rho= 0.28–0.51, that is, ‘less’ ADL-like items). Admission and discharge FIM, NIHSS, and proportion of home discharges were higher with more favorable SULCS hand categories. Floor effect was 11.9% and ceiling effect was 14.7% with an acceptable internal consistency (Cronbach’s alpha of 0.92). The SULCS is a valid measure of upper extremity capacity at admission to inpatient stroke rehabilitation. Further examination regarding ceiling effects and responsiveness in inpatient stroke rehabilitation is recommended.

Development and validation of clinical prediction model for functional independence measure following stroke rehabilitation

 Survivors don't need useless prediction models. They want EXACT 100% RECOVERY PROTOCOLS! Why are you doing useless research? I'd have everyone here fired!

Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? When these persons become the 1 in 4 per WHO that has a stroke: they'll want 100% recovery and by then it will be too late. 

Development and validation of clinical prediction model for functional independence measure following stroke rehabilitation

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https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108185

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Abstract

Objectives

To develop and internally validate a clinical prediction model that includes balance ability and nutritional indices for the motor-functional independence measure (M-FIM) at 90 days post-stroke stroke.

Materials and Methods

This retrospective, single-center study included 566 patients with stroke undergoing rehabilitation at our rehabilitation hospital. The primary outcome was the M-FIM score of >61 at 3 months post-strokes onset. Stepwise conditional forward selection was first used to identify predictors for the achievement of M-FIM>61 at 90 days post-stroke, from 25 potential predictors at admission. The selected predictors were dichotomized with cut-off values to establish scoring systems, resulting in the B-ADL model, which includes postural balance (B), albumin level, age, arm function (A), days since stroke onset (D), and level of activities of daily living (ADL) (L). For internal validation, we corrected the optimism of the area under the curve of receiver operating characteristic curve (AUROC) induced by overfitting the original data using the bootstrap validation method. Calibration capacity was assessed using a calibration plot.

Results

We developed a clinical model to predict the M-FIM at 90 days post-stroke onset. The AUROC of the B-ADL model was 0.92 (sensitivity, 93.7%; specificity, 89.7%). The B-ADL model showed high accuracy with an AUROC of 0.970 in the internal validation. The scoring system in the validation cohort had a cut-off value of 5.5/12 points to predict the achievement of M-FIM>61 (AUROC: 0.950; 95% CI 0.930–0.970).

Conclusions

The B-ADL model accurately predicted M-FIM >61 at 90 days post-stroke on the day of admission to the recovery rehabilitation ward. The B-ADL model is useful for optimizing rehabilitation programs and resource allocation, allowing for targeted interventions after stroke.

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Keywords

Stroke

Prediction

Activities of daily living

Functional independence measure

Rehabilitation

Introduction

Stroke significantly affects the activities of daily living (ADL), with reports indicating that between 13%–35% of stroke survivors require assistance with physical activities.^1,2 Furthermore, a decline in ADL among individuals with stroke is associated with their discharge destinations and decreased quality of life (QOL).^3,4 Therefore, accurate prediction of future ADL levels is essential for planning and tailoring rehabilitation programs to address individual needs and potential recovery trajectories after stroke.

The level of ADL after stroke can be influenced by various factors. Previous studies have shown that the important factors affecting the ADL during stroke rehabilitation include age, sex, stroke subtype, nutritional status, extent of motor impairment, postural balance, cognitive function and muscle strength of the ipsilesional (less affected) upper and lower limbs.5, 6, 7, 8, 9, 10, 11 Specifically, there are reports that the postural balance ability and nutritional status of stroke patients at the time of admission are related to ADL at the end of rehabilitation.^6,11 Therefore, the clinical practice of stroke rehabilitation requires comprehensive assessment of factors affecting ADL levels.

However, the clinical utility of existing clinical prediction models for ADL in stroke rehabilitation is limited for several reasons. First, existing clinical prediction models for FIM after the subacute phase lack consideration of postural balance and blood test assessment including nutritional status as predictive indicators for the future level of ADL.^6,12 Second, most prediction models exclude severe cases with sudden deterioration following the time of prediction implementation; thus, the predictive models for severe cases are insufficient.⁷ Third, there have been reports of insufficient validation and poor utility of these models at an individual level.¹³ Therefore, it is crucial to develop a clinical prediction model that encompasses comprehensive predictors and is applicable developing a clinical prediction model that encompasses comprehensive predictors and is applicable to a broad spectrum of patients with subacute stroke.

This study aimed to develop a clinical prediction model to predict the achievement of M-FIM>61 stroke rehabilitation by adding assessments of postural balance and blood tests during the subacute stroke phase. We hypothesized that incorporating these factors would improve the accuracy of the prediction model.

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Predictors of patient length of stay post stroke rehabilitation

Why do this research? Survivors don't care about length of stay. They want to know EXACTLY HOW YOU'RE GETTING THEM RECOVERED! 

You look at their objective damage diagnosis, which leads to exact protocols to recover from such damage. Then you look at how long it takes survivors to complete those protocols to recovery. Simple, WHY IS NOBODY DOING THAT?

 Predictors of patient length of stay post stroke rehabilitation

Thea Bijl, Witness Mudzi, Nicolette Comley-White
DWhy do this researchepartment of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand.

Abstract

Background: 

 

There is little research on length of hospital stay (LOS) in patients post stroke in South African rehabilitation
facilities. As LOS is an important indicator of cost-of-care, this information may be useful to all stakeholders.
 

Objectives: 

 

To determine the predictors of hospital LOS in patients post stroke rehabilitation.
 

Methods: 

A retrospective file review of 243 patients.
 

Results: 

 

Patient functional ability was measured using the Functional Independence Measure (FIM). Predictors of LOS were determined with multiple regression analysis. The median admission and discharge FIM scores were 43 (range: 16-119) and 75(range: 16-120) points respectively. The median LOS was 43 (range: 3-112) days. Predictors of LOS were premorbid psychiatric conditions, impaired speech, requiring oxygen support, the development of pneumonia and admission FIM motor score, with
admission FIM motor score being the strongest individual predictor of LOS (41%).
 

Conclusion: 

 

Admission FIM score had an influence on patient outcomes and LOS. Patients with higher admission FIM motor scores may be able to participate in rehabilitation better and thus have shorter LOS. Being able to predict LOS on admission allows facility administrators to manage bed occupancy, human and clinical resources in post stroke rehabilitation.
 

Keywords: 

 

Length of stay; predictors; rehabilitation; stroke.
DOI: https://dx.doi.org/10.4314/ahs.v23i2.63
Cite as: Bijl T, Mudzi W, Comley-White N. Predictors of patient length of stay post stroke rehabilitation. Afri Health Sci. 2023;23(2):543-52.
https://dx.doi.org/10.4314/ahs.v23i2.63

Stroke Rehabilitation: AB No: 103: Correlation between Functional Independence, Depression Anxiety and Community Integration in subjects with Post Stroke Hemiparesis

With NO protocols to get you 100% recovered  of course there is going to be depression, anxiety and lack of community integration. And you needed research to tell you that? Can you actually think with those two functioning neurons you seem to have?

 Stroke Rehabilitation: AB No: 103: Correlation between Functional Independence, Depression Anxiety and Community Integration in subjects with Post Stroke Hemiparesis

Purpose: 

To correlate functional independence, depression anxiety and community integration in post stroke hemiparesis. 

 

Relevance: 

In subjects with post stroke due to primary and secondary impairments there may be restriction in functional independency also may have depression anxiety and problem in community participation. Hence it is necessary to find out correlation between functional independence, depression anxiety and community integration.  

 

Participants: 

67 participants from SBB college of physiotherapy, SVP hospital. Post stroke males and females of age 35 to 75 years, both ischemic and haemorrhagic stroke subjects were included and visual auditory deficits subjects were excluded in the study by convenient sampling. 

 

Methodology: Cross sectional study was conducted. After taken a consent, fill up the scales by asking questions to the subjects. Functional independence measures scale, Depression, anxiety and stress scale and Community integration questionnaires.  

 

Analysis: Data analysis for 15 subjects was done using SPSS version 20 and Microsoft excel 2019. For data screened nonparametric Spearman correlation coefficient test was used. Level of significance kept at 5 %. 

 

Results: 

Results show that there is moderate negative correlation between FIM and DASS (r = -0.571, r = < 0.05) moderate positive correlation between FIM and CIQ (r = 0.535, r = 0.05) and moderate negative correlation between DASS and CIQ (r = -0.526,r = < 0.05) in subjects with post stroke hemiparesis.  

 

Conclusion: 

functional independence measures (FIM) is positively correlate with community integration (CIQ) and negatively correlate with depression anxiety (DASS) and depression anxiety (DASS) is negatively correlate with community integration (CIQ).

Priya Darji, Shraddha Diwan  SBB College of Physiotherapy Correspondence Address: Source of Support: None, Conflict of Interest: None DOI: 10.4103/2456-7787.361067

Relationship of Functional Outcome With Sarcopenia and Objectively Measured Physical Activity in Patients With Stroke Undergoing Rehabilitation

NO, NO, NO, not this useless shit. Give us protocols on how to prevent sarcopenia.

Sarcopenia is a progressive and generalised skeletal muscle disorder involving the accelerated loss of muscle mass and function that is associated with increased adverse outcomes including falls, functional decline, frailty, and mortality

Relationship of Functional Outcome With Sarcopenia and Objectively Measured Physical Activity in Patients With Stroke Undergoing Rehabilitation

in Journal of Aging and Physical Activity

Masashi Kanai¹, Masafumi Nozoe^*,1, Takuro Ohtsubo², Iori Yasumoto², and Katsuhiro Ueno²

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DOI:

https://doi.org/10.1123/japa.2022-0025

Keywords:

physical functional performance; muscular atrophy; physically disabled; motor activity; neurological rehabilitation

First Published Online:

23 Apr 2022

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1–6

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• Abstract
• Author Notes

This study aimed to investigate the relationship(I would have the mentors and senior researchers fired for this lazy crapola! Nothing here helps survivors recover.) of Functional Independence Measure for motor function (FIM-M) with sarcopenia, and physical activity in patients with stroke undergoing rehabilitation. This cross-sectional study included patients with stroke at a single convalescent rehabilitation hospital. Sarcopenia was diagnosed based on the Asia Working Group for Sarcopenia 2019 criteria. Physical activity was measured as the duration of light-intensity physical activity and moderate to vigorous physical activity using a triaxial accelerometer. Of 80 patients (median age: 72.0 years), 46 (57.5%) were diagnosed with sarcopenia. In multivariate linear regression analysis, FIM-M score was significantly associated with sarcopenia (β = −0.15, p = .043) and light-intensity physical activity (β = 0.55, p < .001). In another model, FIM-M score was significantly associated with moderate to vigorous physical activity (β = 0.27, p = .002) but not with sarcopenia. This study demonstrated that FIM-M was partially associated with sarcopenia and associated with physical activity regardless of intensity in patients with stroke.

 

Combination of Serum Neurofilament Light Chain Levels and MRI Markers to Predict Cognitive Function in Ischemic Stroke

Survivors don't give a crap about your fucking failure to recover predictions. They want specific recovery rehab options. 

WHEN THE HELL WILL YOU DO THAT?

 Combination of Serum Neurofilament Light Chain Levels and MRI Markers to Predict Cognitive Function in Ischemic Stroke

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Yuan Peng, MD, PhD*, Qianfeng Li, MD*, Lei Qin, PhD, ...

First Published February 1, 2021 Research Article 

https://doi.org/10.1177/1545968321989354

Article information

 

Abstract

Background:

It is important to predict poststroke cognitive outcome to guide individualized treatment and prevention strategy. We aimed to evaluate the predictive value of the combination of a serum biomarker for axonal damage (neurofilament light chain [NfL]) and neuroimaging markers (volume of infarction and white matter hyperintensities [WMH]) for neuronal abnormality in poststroke cognitive outcome.

Methods:

A total of 1028 patients were screened; among them, 144 patients with acute ischemic stroke (stroke group) and 30 patients without stroke (control group) were enrolled. Serum NfL levels of samples obtained from both groups were measured through single molecule array assay. Neuroimaging markers of neuroaxonal injury, including infarct volume and WMH in the stroke group were quantified on magnetic resonance images using an in-house MATLAB code (MATLAB 2017; MathWorks). The primary outcome was the functional independence measure (FIM) cognitive subscores on discharge. We assessed the association of serum NfL levels and neuroimaging markers with cognitive outcome. The prognosis value of the combination of serum NfL levels and imaging markers for predicting FIM cognitive subscores on discharge was calculated using the area under curve (AUC) of the receiver operating characteristic.

Results:

Serum NfL levels of the stroke group were 9-fold higher than those of the control group (1449.7 vs 157.2 pg/mL, n = 144/30, P < .001). There was a correlation of serum NfL levels with infarct volume (r = 0.530, P < .001) and functional outcome, including FIM cognitive subscores (r = −0.387, P < .001) and FIM motor subscores on admission (r = −0.306, P < .001), but not with WMH volume after adjusting for infarct volume (r = −0.196, P = .245). Serum NfL levels on admission independently predicted poststroke FIM cognitive subscores on discharge (AUC = 0.672, P < .001). The predictive value for poststroke cognitive outcome was improved by combining serum NfL levels with infarct and WMH volume (AUC = 0.760, P < .001).

Conclusion:

The combination of serum NfL levels with volume of infarct and WMH shows an improved predictive value for cognitive function during acute rehabilitation phase after stroke, providing a promising panel of biomarkers for prognosis and guidance of treatment.(But you give us no guidance. Useless crapola here.)

Keywords ischemic stroke, cognitive function, FIM, functional independence measure, infarct volume, white matter hyperintensities, neurofilament light chain

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Explanatory variables to use in a multiple regression analysis to predict stroke patients’ motor FIM score at discharge from convalescent rehabilitation wards: an investigation of patients with a motor FIM score of less than 40 points at admission

Damn it all, Quit trying to predict failure to recover. Survivors want 100% recovery.  Do the research to get there. 

 Explanatory variables to use in a multiple regression analysis to predict stroke patients’ motor FIM score at discharge from convalescent rehabilitation wards: an investigation of patients with a motor FIM score of less than 40 points at admission

Makoto Tokunaga, MD, PhD,1
 Katsuhiko Sannomiya, PT2
1
 Department of Rehabilitation Medicine, Kumamoto Kinoh Hospital, Kumamoto, Japan
2
 Department of Physical Therapy, Kumamoto Kinoh Hospital, Kumamoto, Japan

ABSTRACT

Objective: 

This study aimed to clarify the explanatory variables to use in a multiple regression analysis to predict improvement in the motor Functional Independence Measure (FIM) during the hospitalization of patients with severe stroke in a convalescent rehabilitation ward.  

Methods: 

The subjects of this study were 230 patients with stroke with a motor FIM score of less than 40 points at admission. In total, 17 factors were stratified and those with a significant difference in motor FIM effectiveness between stratified groups were used as the explanatory variables of a stepwise regression analysis, which employed the motor FIM score at discharge as the objective variable. 

Results: 

There were significant differences in motor FIM effectiveness among the 12 factors. The 10 factors selected through a stepwise regression analysis were age, cognitive FIM score at admission, motor FIM score at admission, number of days from onset to admission, modified Rankin Scale before onset, Brunnstrom stage of paralyzed lower limb, body mass index, sitting stability, Japan Coma Scale, and hemispatial neglect. 

Conclusion: 

It is desirable to use these 10 factors as explanatory variables in multiple regression analyses.

Subgroups defined by the Montreal cognitive assessment differ in functional gain during acute inpatient stroke rehabilitation

And what EXACTLY  are you doing so ALL GROUPS get functional gains to 100% recovery?  Yes, that will be difficult, but leaders tackle and solve difficult problems. Are you a leader or a mouse? Leave no survivor behind. I absolutely hate recovery predictions because they mean useful research was not done and they don't help one whit in getting survivors recovered.  Until stroke leadership understands that survivors will be screwed.

Subgroups defined by the Montreal cognitive assessment differ in functional gain during acute inpatient stroke rehabilitation

Archives of Physical Medicine and Rehabilitation , Volume 101(2) , Pgs. 220-226.

NARIC Accession Number: J83113.  What's this?
ISSN: 0003-9993.
Author(s): Jaywant, Abhishek; Toglia, Joan; Gunning, Faith M.; O'Dell, Michael W..
Publication Year: 2020.
Number of Pages: 7.

Abstract: 

Study validated subgroups of cognitive impairment on the Montreal Cognitive Assessment (MoCA)-defined as normal (score of 25-30), mildly impaired (score of 20-24), and moderately impaired (score less than 19)-by determining whether they differ in rehabilitation gain during inpatient stroke rehabilitation. Linear regression models were conducted and predictors included MoCA subgroups and relevant baseline demographic and clinical covariates. Separate models included the cognitive subscale of the Functional Independence Measure (FIM) instrument as a predictor. Participants were 334 patients with mild-moderate strokes who were administered the MoCA on admission to the inpatient rehabilitation facility of an urban, academic medical center. Outcome variables included the mean relative FIM gain (mRFG), which quantifies the amount of functional gain achieved as a percentage of the total functional gain possible, and mean relative functional efficiency (mRFE), which adjusts for length of stay) on the FIM total. MoCA subgroups significantly predicted mRFG and mRFE after accounting for age, sex, education, stroke severity, and recurrent vs first stroke. The normal group exhibited greater mRFG and mRFE than the mildly impaired group, while the moderately impaired group had significantly worse mRFG and mRFE than the mildly impaired group. The moderately impaired group had a significantly smaller proportion of individuals who made a clinically meaningful change on the total-FIM than the mildly impaired and normal groups. MoCA subgroups better accounted for mRFG and mRFE than a standard-of-care cognitive assessment (cognitive-FIM). Use of MoCA-defined subgroups can assist providers in predicting(There is that useless term again.)  functional gain in survivors of stroke being treated in inpatient rehabilitation.
Descriptor Terms: CLIENT CHARACTERISTICS, COGNITIVE DISABILITIES, DEMOGRAPHICS, FUNCTIONAL EVALUATION, MEASUREMENTS, OUTCOMES, PERFORMANCE STANDARDS, REHABILITATION, STROKE


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Jaywant, Abhishek, Toglia, Joan, Gunning, Faith M., O'Dell, Michael W.. (2020). Subgroups defined by the Montreal cognitive assessment differ in functional gain during acute inpatient stroke rehabilitation.  Archives of Physical Medicine and Rehabilitation , 101(2), Pgs. 220-226. Retrieved 4/17/2020, from REHABDATA database.

Functional Performance and Discharge Setting Predict Outcomes 3 Months After Rehabilitation Hospitalization for Stroke

Survivors don't care about predictions, they want rehab interventions that lead to recovery results. DO THE DAMN RESEARCH THAT WILL GET THERE. Not this lazy prediction crapola.  Have you ever talked to patients about what they want? I would have you all fired, including your mentors and senior researchers.

 

Functional Performance and Discharge Setting Predict Outcomes 3 Months After Rehabilitation Hospitalization for Stroke

Author links open overlay panelAllen W.BrownMD*

MelodyLeeMD*Ryan J.LennonMS^†Paulette M.NiewczykPhD, MPH^‡

https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104746Get rights and content

Abstract

Background

Some clinical features of patients after stroke may be modifiable and used to predict outcomes. Identifying these features may allow for refining plans of care and informing estimates of posthospital service needs. The purpose of this study was to identify key factors that predict functional independence and living setting 3 months after rehabilitation hospital discharge by using a large comprehensive national data set of patients with stroke.

Methods

The Uniform Data System for Medical Rehabilitation was queried for the records of patients with a diagnosis of stroke who were hospitalized for inpatient rehabilitation from 2005 through 2007. The system includes demographic, administrative, and clinical variables collected at rehabilitation admission, discharge, and 3-month follow-up. Primary outcome measures were the Functional Independence Measure score and living setting 3 months after rehabilitation hospital discharge.

Results

The sample included 16,346 patients (80% white; 50% women; mean [SD] age, 70.3 [13.1] years; 97% ischemic stroke). The strongest predictors of Functional Independence Measure score and living setting at 3 months were those same factors at rehabilitation discharge, despite considering multiple other predictor variables including age, lesion laterality, initial neurologic impairment, and stroke-related comorbid conditions.

Conclusions

These data can inform clinicians, patients with stroke, and their families about what to expect in the months after hospital discharge. The predictive power of these factors, however, was modest, indicating that other factors may influence postacute outcomes. Future predictive modeling may benefit from the inclusion of educational status, socioeconomic factors, and brain imaging to improve predictive power.

Key Words

Community

nursing home

outcome

rehabilitation

Abbreviation

FIM

Functional Independence Measure

ICD-9-CM

International Classification of Diseases

9th edition

Clinical Modification

UDSMR

Uniform Data System for Medical Rehabilitation