The effects of rehabilitation potential on activities of daily living in patients with stroke in Taiwan: a prospective longitudinal study.
Ying-Tzu Tseng, Der-Sheng Han, Jerry Cheng-Yen Lai and 3 others
PMID 39439176WHAT IT FOUND
Daily living improved most before discharge, then flattened.
Better swallowing, lower-limb strength and motivation, plus no incontinence or moderate cognitive impairment, were linked with higher daily living scores.
Key findings
01Daily living scores rose sharply before discharge and then flattened after discharge.
02Higher swallowing ability, lower-limb muscle power and rehabilitation motivation were linked with higher daily living scores, while urinary incontinence and moderate cognitive impairment were linked with lower scores.
03Compared with patients who had low swallowing ability and low rehabilitation motivation, patients with other combinations of swallowing ability and motivation had higher daily living scores.
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 was observational, so it cannot show that any rehabilitation-potential indicator caused better daily living. All participants came from one medical centre, although it is the largest national referral centre in Taiwan. Data collection changed from face-to-face interviews to face-to-face or telephone interviews, and the authors say a mode effect cannot be ruled out between the first and third waves. Attrition occurred: 98 of 101 completed the second wave and 93 completed the third wave. Patients were adults with modified Rankin Scale scores of 3-5 who were transferred to a rehabilitation ward, so findings may not apply to other stroke groups or settings. The socioeconomic dimension used only social support and additional private insurance, and the authors say other socioeconomic indicators may matter. Life goals and reasons for pursuing rehabilitation were not measured. Generalisation to different countries or sociocultural backgrounds is uncertain.
Declared interests
The authors declared no conflicts of interest. The study was supported by National Taiwan University Hospital grant 109-004484, and the funding source had no influence on the study or article preparation.
The easy way to misread this
Do not read the swallowing, motivation and daily living links as proof that a treatment caused improvement. This was a longitudinal observational study, and no therapy was tested.