Relationship between Barthel Index scores during the acute phase of rehabilitation and subsequent ADL in stroke patients

概要

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The Barthel Index (BI) cannot be used to measure initial stroke severity or byextension, to stratify patients by severity in acute stroke trials because most patients arebedbound in the first few hours after stroke, either by their deficit or by medical directive.Our objectives were to clarify the threshold of acute BI for use in the prediction ofsubsequent independence in activities of daily living (ADL) and to assist in the definitionof acute stroke rehabilitation goals. Subjects comprised 78 patients out of 191 inpatientsadmitted with acute stroke at our hospital during 2006-2007. The BI ADL score wasdivided into 2 ranges (BI 60 and 40), in a process similar to previous studies. During theacute period (from onset to approximately 3 weeks), all patients with a BI 40 could improvetheir ADL in 6 months. Patients with a BI 40 exhibited two ADL recovery outcomes(improved and no change) at 6 months. We also found that the skill level of basicactivities related to standing was significant indicator of BI improvement (P<0.001). BIscores determined at approximately 3 weeks were reliable predictors of ADL disabilitiesat 6 months.