Time-course for acquiring transfer independence in patients with subacute stroke: a prospective cohort study

Abstract

Objective: To clarify the time-course of longitudinal changes in the independence level of subtasks composing bed–wheelchair transfer among patients with stroke. Design: Single-institution prospective cohort study. Patients: A total of 137 consecutive post-stroke patients using wheelchair on admission to the subacute rehabilitation wards. Methods: The independence degree in each of the 25 transfer-related subtasks was assessed using the Bed–Wheelchair Transfer Tasks Assessment Form on a three-level scale every two weeks, from admission to the endpoint (either discharge or when achieving independent transfer). Patients were classified based on admission and endpoint assessment form scores using two-step cluster analysis. Results: Patients were classified into three clusters. The first cluster included 50 patients who exhibited a greater independence level in all subtasks on admission (52.0–100% of patients performed each subtask independently) and at the endpoint (64.0–100%). The second included 30 patients who showed less independence on admission (0–27.8%) but achieved greater independence levels at the endpoint (44.4–97.2%). The third included 51 patients whose independence level remained low in many subtasks from admission (0–5.8%) until the endpoint (0–29.4%). Conclusion: The independence level and its changing process during transfer were categorized into three time-courses, each requiring different intervention strategies.

Keywords

• activities of daily living
• cerebrovascular disorders
• cluster analysis
• task performance
• wheelchair