Predictive validity of elderly mobility scale on rehabilitation outcomes of patients suffered from stroke

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Predictive validity of elderly mobility scale on rehabilitation outcomes of patients suffered from stroke

 

Author: Fung, Hok-kwan
Title: Predictive validity of elderly mobility scale on rehabilitation outcomes of patients suffered from stroke
Degree: M.Sc.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Cerebrovascular disease -- Patients -- Rehabilitation
Older people -- Orientation and mobility
Department: Dept. of Rehabilitation Sciences
Pages: x, 72 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1724860
URI: http://theses.lib.polyu.edu.hk/handle/200/1982
Abstract: Mobility is perhaps the ability that stroke patients consider most important. A widely used instrument in local settings, the Elderly Mobility Scale (EMS), has been shown to be valid and reliable in assessing mobility functions of frail elderly people. The purpose of this study is to further evaluate the concurrent and predictive validity of the EMS. It aims at examining the relationship of the EMS with other measures on balance, cognitive and functional performance, and investigating its predictability on discharge functional status and the length of hospital stay of patients after receiving stroke rehabilitation. Mobility, balance, cognitive, and functional perforamce are measured by the EMS, Berg Balance Scale (BBS), Cantonese version of Mini-Mental State Examination (CMMSE), and Modified Barthel Index (MBI) respectively. The severity of neurological deficit at stroke onset assessed by the National Institutes of Health Stroke Scale (NIHSS) was retrieved from case files. The EMS, BBS, and MBI were assessed at admission, week-2, and discharge. The CMMSE was assessed at admission. In the analysis, the data came from a total of 22 patients with first acute stroke at mean age 70.5 years (SD=5.9) completed all assessment occasions and were discharged home after stroke rehabilitation. Pearson correlation coefficient was used to examine the relationship of the EMS with the BBS, CMMSE and MBI. Forward stepwise multiple regression analysis was performed to evaluate the significant beta weight of different predictors for discharge functional performance and the length of stay. The results demonstrated that at admission, there were significant relationships between the EMS and BBS (r=0.92) and MBI (r=0.95). However, the correlation between the EMS and CMMSE was insignificant (r=0.17). At week-2, there were very strong relationships between the EMS and BBS (r=0.98) and MBI (r=0.96). At discharge, the correlations between the EMS and BBS (r=0.99) and MBI (r=0.94) were very high, indicating strong relationships between them. At admission, the EMS was the only significant predictor for discharge functional performance and the length of stay. It explained a total of 62% of the variance of functional performance and 61% of the total variance of LOS. Both predictors, the admission EMS and NIHSS, explained 72% of the total variance of discharge functional performance. At week-2, the BBS scores explained 74% of the total variance of discharge functional performance. The evidence from this study demonstrates that the EMS has concurrent validity with BBS and MBI. The EMS is valid in measuring mobility function and predicting outcomes of stroke rehabilitation in elderly population. This study further demonstrates the importance for rehabilitation therapists to monitor motor recovery, especially mobility and balance abilities in stroke rehabilitation. Intensive training to restore these functions is indispensable in order to promote efficient functional regain and shorten length of hospital stay.

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