Task-specific motor-cognitive correlates of dressing independence after stroke: a multicenter cross-sectional study.

Abstract

This exploratory multicenter cross-sectional study examined motor, sensory, and cognitive correlates of upper- and lower-body dressing independence after stroke. Participants were 165 patients with stroke from eight hospitals in Japan. Dressing independence was assessed using the Functional Independence Measure. Candidate predictors included demographic and clinical covariates, motor and trunk-related measures, sensory-perceptual measures, and cognitive tests. Elastic net regression with 5-fold cross-validation was performed separately for upper- and lower-body dressing. The L1 ratio was fixed at 0.5, and alpha was selected by cross-validation. Forced-entry multiple regression using the same predictor set was conducted as a supplementary analysis. Elastic net models retained motor impairment, abdominal function, and knee extensor strength for both dressing outcomes, with larger coefficients for lower-body dressing. Sensory, visuospatial, cognitive, and clinical variables had smaller coefficients. Supplementary regression associated motor impairment with both outcomes and knee extensor strength and abdominal function with lower-body dressing. Motor impairment, abdominal function, and knee extensor strength were important model variables. Findings support component-level assessment of dressing performance but remain hypothesis-generating because of the cross-sectional design.