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Kimura Y, Ohji S, Nishio N, Abe Y, Ogawa H, Taguchi R, Otobe Y, Yamada M. The impact of wheelchair propulsion based physical activity on functional recovery in stroke rehabilitation: a multicenter observational study. Disabil Rehabil 2020; 44:2027-2032. [PMID: 33026844 DOI: 10.1080/09638288.2020.1821249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE We aimed to evaluate the relationship between the daily wheelchair self-propulsion distance and functional recovery in subacute stroke survivors. METHODS Seventy-four patients with stroke were prospectively recruited from four convalescent rehabilitation hospitals. All participants were unable to walk independently and required manual wheelchairs for locomotion on admission. The daily wheelchair self-propulsion distance was measured using a cycle computer that was connected to a touch switch to exclude the assistance-propulsion distance. The outcome measures were represented as the relative gain of the Functional Independence Measure (FIM) effectiveness during hospitalization. Moreover, a better functional recovery was defined as a FIM effectiveness > 50%. Participants were categorized into three groups according to tertiles of the average daily wheelchair self-propulsion distance: lowest tertile (T1, ≤0.59 km/day); middle tertile (T2, 0.60-1.23 km/day); and highest tertile (T3, ≥1.24 km/day). RESULTS Multivariate logistic regression analysis adjusted for baseline characteristics showed that the T2 and T3 groups had a significant association with better FIM effectiveness, and their odds ratios (95% confidence interval, p) were 7.26 (1.13-45.85, p = .038), and 10.19 (1.15-91.75, p = .035), respectively. CONCLUSIONS The daily wheelchair self-propulsion distance was significantly associated with functional recovery in subacute stroke survivors.IMPLICATIONS FOR REHABILITATIONNon-ambulatory stroke survivors can obtain extra independent physical activity by using wheelchair self-propulsion, when they do not have someone to assist them with walking.This multicenter observational study revealed that the self-propulsion distance of a manual-wheelchair was significantly associated with functional recovery in subacute stroke survivors.
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Affiliation(s)
- Yosuke Kimura
- Department of Rehabilitation, Tokyo Shinjuku Medical Center, Japan Community Health care Organization, Tokyo, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Shunsuke Ohji
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Naohito Nishio
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Physical Therapy, Saitama Prefectural Rehabilitation Center, Saitama, Japan
| | - Yuki Abe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Rehabilitation Medicine, Kiminomori Rehabilitation Hospital, Chiba, Japan
| | - Hideyuki Ogawa
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Physical Therapy, Saitama Prefectural Rehabilitation Center, Saitama, Japan
| | - Ryota Taguchi
- Department of Rehabilitation Medicine, Kiminomori Rehabilitation Hospital, Chiba, Japan.,Department of Rehabilitation Medicine, Saitama Memorial Hospital, Saitama, Japan
| | - Yuhei Otobe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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