Identifying profiles of stroke patients benefitting from additional training: a latent class analysis approach.
Kohei Ikeda, Takao Kaneko, Junya Uchida and 3 others
PMID 38380814WHAT IT FOUND
Additional training improved daily living scores only for a specific group: patients aged 65-84 with right-side paralysis and moderate dependence.
For this group, combining self-exercise with staff-led training worked best. Other patient profiles showed no significant benefit from these additions.
Key findings
01Additional training significantly improved Functional Independence Measure (FIM) scores only for patients in Class 2, who were aged 65-84 with right hemiplegia and modified dependence.
02For Class 2 patients, the combination of self-exercise and training with hospital staff resulted in significantly higher FIM scores compared to usual care alone.
03Patients in the most severe dependence classes (Class 3 and 5) or the most independent classes (Class 1 and 6) did not show significant gains from additional training.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is observational, not randomized, so baseline differences between groups may have influenced results despite statistical adjustments. Detailed information on the specific content, frequency, and duration of additional training was lacking, making it difficult to replicate the exact intervention. The database did not include information on stroke localization, so the role of specific brain lesions could not be assessed. Results may not generalize to all types of additional training, as only self-exercise and staff-led training were analyzed. Ceiling effects likely limited observed gains for patients who were already highly independent at admission.
Declared interests
The authors declare no conflicts of interest. The study was supported by JSPS KAKENHI (grant number JP20H03914).
The easy way to misread this
Do not apply these findings to all stroke patients. The benefit of additional training was limited to a specific subgroup (right hemiplegia, moderate dependence, age 65-84). Patients with left hemiplegia, severe cognitive or motor dependence, or those already highly independent did not show significant gains, so prescribing intensive additional training for these groups may not be effective.