Differences in factors associated with stair-climbing ability at discharge based on the severity of lower limb paralysis in patients with stroke.

Abstract

Background: Obtaining stair-climbing ability at discharge is crucial, and identifying the predictors of independent stair-climbing ability is important for making rehabilitation more effective.

Objectives: This study aimed to clarify the factors associated with stair climbing at discharge in patients with stroke classified according to the severity of lower limb paralysis.

Method: This study is a multi-institutional retrospective observational study included patients with acute ischemic stroke and intracerebral hemorrhage. Patients were classified into the severe group and the mild groups based on the severity of their lower limb function. Multiple logistic regression analysis was performed for all included patients and each severity group to investigate factors associated with stair-climbing ability at discharge.

Results: We included 2,097 patients (41.5 % female) with a median age (interquartile range) of 75 (66-83) years in the present analysis. Overall, 105 (19.6 %) patients in the severe group were able to stair climbing independently and 1,069 (68.5 %) in the mild group were able to climb stairs independently. Predictors independently associated with stair-climbing ability in the severe group included age, paralyzed side, sitting ability, acute length of stay (acute LOS), and functional independence measure (FIM) motor items. Predictors in mild group were age, stroke type, upper limb function, sitting ability, acute LOS, FIM motor, FIM cognitive.

Conclusions: The predictors of stair-climbing ability differed according to the severity of lower limb paralysis. The results of this study can be used to predict the prognosis of stair-climbing ability to support goal setting and decision-making in rehabilitation treatment.