Change in mobility activity in the second year after stroke in a rehabilitation population: who is at risk for decline?

Arch Phys Med Rehabil. 2006 Jan;87(1):45-50. doi: 10.1016/j.apmr.2005.08.118.


Objectives: To investigate the development of mobility status during the second year after stroke in patients who had had inpatient rehabilitation, and to evaluate risk factors for mobility decline.

Design: Evaluation of change in Rivermead Mobility Index (RMI) score over the second year after stroke in an inception cohort of first-ever stroke patients eligible for inpatient rehabilitation. Logistic regression techniques were used to predict decline. Independent variables were measured with standardized instruments 1 year after stroke.

Setting: Home or institution, after discharge from rehabilitation center.

Participants: Patients (N=148) with single first-ever stroke (supratentorial), age more than 18 years.

Interventions: Not applicable.

Main outcome measures: Decline of 2 or more points on the RMI and the percentages and odds ratios (ORs) for decline.

Results: The mean RMI score did not significantly change over time. Mobility declined in 12% of the patients. Mobility decline was found more often in patients with depression (25%) than without (7%), with right-sided weakness (17% vs 8%), with ischemic stroke (13% vs 8%), with aphasia (22% vs 11%), with cognitive dysfunction (17% vs 11%), with comorbidity interfering with locomotion (25% vs 12%), with poor social functioning (15% vs 10%), and with mobility disability (16% vs 8%). Statistical significance was found only for depression (OR=4.2; 95% confidence interval, 1.3-13.2).

Conclusions: Most patients maintained the level of mobility they achieved during inpatient rehabilitation over the second year after stroke. Only 12% had a decline in mobility, and depression was the only statistically significant predictor for decline.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Disability Evaluation
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Patient Discharge
  • Physical Therapy Modalities
  • Probability
  • Recovery of Function / physiology*
  • Rehabilitation Centers
  • Risk Factors
  • Statistics, Nonparametric
  • Stroke / diagnosis*
  • Stroke Rehabilitation*
  • Time Factors