Early multidimensional mobility assessments for discriminating discharge-level ambulation and functional independence in subacute stroke inpatients: a retrospective cohort study.

Abstract

To examine whether early multidimensional mobility assessments discriminate independent ambulation and functional independence on discharge in subacute stroke inpatients with supervised walking ability. Retrospective cohort study. Fifty subacute stroke inpatients (≤ 5 months post-stroke). Independent ambulation and functional independence were defined as Functional Ambulation Category ≥ 4 and Modified Barthel Index 75 on discharge, respectively. Discriminative ability of admission assessments was evaluated using univariate binary logistic regression and receiver operating characteristic curve analysis. The Berg Balance Scale and the modified Four Square Step Test demonstrated the highest discriminative performance. For independent ambulation, the Berg Balance Scale (≥ 40.5) yielded an area under the curve of 0.74 (95% confidence interval: 0.60-0.88) with 82% accuracy, and the modified Four Square Step Test (≤ 31.52 s) yielded an area under the curve of 0.78 (0.64-0.91) with 80% accuracy. For functional independence, the Berg Balance Scale (≥ 42.5) yielded an area under the curve of 0.74 (0.60-0.88) with 74% accuracy, and the modified Four Square Step Test (≤ 32.88 s) yielded an area under the curve of 0.71 (0.57-0.86) with 70% accuracy. Early balance and multidirectional stepping performance may be useful for screening to support goal-setting and discharge planning.