Takaaki Fujita1, Atsushi Sato2, Kenji Tsuchiya3, Takuro Ohashi4, Kazuhiro Yamane4, Yuichi Yamamoto4, Kazuaki Iokawa5, Yoko Ohira4, Koji Otsuki4, Fusae Tozato6. 1. Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Japan. Electronic address: t-fujita@tfu-mail.tfu.ac.jp. 2. Department of Physical Therapy, Yachiyo Rehabilitation College, Japan. 3. Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Japan. 4. Department of Rehabilitation, Northern Fukushima Medical Center, Japan. 5. Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Japan. 6. Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Japan.
Abstract
BACKGROUND: This study aimed to elucidate the relationship between grooming performance of stroke patients and various motor and cognitive functions and to examine the cognitive and physical functional standards required for grooming independence. METHODS: We retrospectively analyzed the data of 96 hospitalized patients with first stroke in a rehabilitation hospital ward. Logistic regression analysis and receiver operating characteristic curves were used to investigate the related cognitive and motor functions with grooming performance and to calculate the cutoff values for independence and supervision levels in grooming. RESULTS: For analysis between the independent and supervision-dependent groups, the only item with an area under the curve (AUC) of .9 or higher was the Berg Balance Scale, and the calculated cutoff value was 41/40 (sensitivity, 83.6%; specificity, 87.8%). For analysis between the independent-supervision and dependent groups, the items with an AUC of .9 or higher were the Simple Test for Evaluating Hand Function (STEF) on the nonaffected side, Vitality Index (VI), and FIM® cognition. The cutoff values were 68/67 for the STEF (sensitivity, 100%; specificity, 72.2%), 9/8 points for the VI (sensitivity, 92.3%; specificity, 88.9%), and 23/22 points for FIM® cognition (sensitivity, 91.0%; specificity, 88.9%). CONCLUSIONS: Our results suggest that upper-extremity functions on the nonaffected side, motivation, and cognitive functions are particularly important to achieve the supervision level and that balance is important to reach the independence level. The effective improvement of grooming performance is possible by performing therapeutic or compensatory intervention on functions that have not achieved these cutoff values.
BACKGROUND: This study aimed to elucidate the relationship between grooming performance of strokepatients and various motor and cognitive functions and to examine the cognitive and physical functional standards required for grooming independence. METHODS: We retrospectively analyzed the data of 96 hospitalized patients with first stroke in a rehabilitation hospital ward. Logistic regression analysis and receiver operating characteristic curves were used to investigate the related cognitive and motor functions with grooming performance and to calculate the cutoff values for independence and supervision levels in grooming. RESULTS: For analysis between the independent and supervision-dependent groups, the only item with an area under the curve (AUC) of .9 or higher was the Berg Balance Scale, and the calculated cutoff value was 41/40 (sensitivity, 83.6%; specificity, 87.8%). For analysis between the independent-supervision and dependent groups, the items with an AUC of .9 or higher were the Simple Test for Evaluating Hand Function (STEF) on the nonaffected side, Vitality Index (VI), and FIM® cognition. The cutoff values were 68/67 for the STEF (sensitivity, 100%; specificity, 72.2%), 9/8 points for the VI (sensitivity, 92.3%; specificity, 88.9%), and 23/22 points for FIM® cognition (sensitivity, 91.0%; specificity, 88.9%). CONCLUSIONS: Our results suggest that upper-extremity functions on the nonaffected side, motivation, and cognitive functions are particularly important to achieve the supervision level and that balance is important to reach the independence level. The effective improvement of grooming performance is possible by performing therapeutic or compensatory intervention on functions that have not achieved these cutoff values.