Investigation of independence in the tasks involving the use of public transportation in patients with subacute stroke.

The study was retrospective and used records from a single rehabilitation hospital in Japan, so the transportation system and patient mix may not apply elsewhere. Only patients expected to use public transport after discharge, wanted by patient or family, and judged necessary by clinicians were included, so it does not describe all subacute stroke patients. Participants had relatively mild impairments, with median MMSE-J 29 of 30 and median FIM motor score 86 of 91, so results may not apply to more severely affected patients. Denominators for task and category analyses varied because not applicable tasks and missing values were excluded. Each patient had one PTAF assessment immediately after practice, so the study does not show change over time, transfer to home, or post-discharge community use. Therapists could provide assistance when they deemed it necessary for safety, so independence scores reflect supervised practice conditions rather than unsupervised real-world travel. The practice courses were hospital-selected and not always the trains and buses participants usually used, so unfamiliar stations and routes may have affected performance.

The authors declared no conflicts of interest.

Do not read the independence rates as evidence that public transportation practice made patients safe or independent after discharge. The patients were selected for expected public transport use, had relatively mild impairments, and were assessed once during inpatient practice without a comparison group.