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Clin Rehabil. 2006 Jun;20(6):523-35.

Dynamic interactions between impairment and activity after stroke: examining the utility of decision analysis methods.

Author information

1
Department of Occupational Therapy, University of Pittsburgh, 5012 Forbes Tower, Pittsburgh, PA 15260, USA. skidmore@pitt.edu

Abstract

OBJECTIVE:

To examine the utility of decision analysis methods for examining the dynamic nature of impairment-activity interactions following stroke.

DESIGN:

Decision analyses (Chi-squared Automatic Interaction Detector) of a prospective cohort study.

SETTING:

Community and institutional settings based on the location of participants three months after stroke.

PARTICIPANTS:

Individuals were recruited from consecutive admissions to a regional academic health center and were assessed three months after stroke (N= 67).

MAIN OUTCOME MEASURES:

Neurological impairment was measured with the National Institutes of Health Stroke Scale (NIHSS). Mobility, self-care and instrumental activities of daily living (instrumental ADL) performance were assessed with a performance observation measure, the Performance Assessment of Self-care Skills (PASS). Decision analysis methods were used to examine interactions between neurological impairments and activity outcomes.

RESULTS:

Unique neurological impairments were associated with each activity outcome (bowel and bladder urgency interacted with mobility; hand function interacted with self-care; mental functions interacted with instrumental ADL), and these findings are supported by previous studies. The predictive validity of mobility and self-care analyses was stronger than the instrumental ADL analyses.

CONCLUSIONS:

Decision analysis methods show promise for understanding dynamic impairment--activity interactions. This understanding may enhance methods for informing rehabilitation decisions.

PMID:
16892934
DOI:
10.1191/0269215506cr980oa
[Indexed for MEDLINE]
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