Article

OBJECTIVES: To determine the rates of manual and powered wheelchair use at
discharge for people with stroke admitted to a rehabilitation center and to
determine whether any predictors of wheelchair use at discharge could be
identified. DESIGN: Retrospective cohort study.
SETTING: Rehabilitation center.
PARTICIPANTS: Consecutive former inpatients (N=100) with a primary diagnosis of
stroke, a sample of convenience. INTERVENTIONS: None. MAIN OUTCOME MEASURES: We
reviewed the inpatient health records to determine the rates of wheelchair use at
discharge and to record some readily available demographic and clinical data that
might serve as predictors of wheelchair use. RESULTS: At discharge, 40 people
(40%) were using manual wheelchairs, 1 person (1%) was using a powered
wheelchair, and 59 (59%) were not using a wheelchair. Of the patients who were
walkers on admission (ie, walking FIM scores of 6 or 7), none (0%) used
wheelchairs at discharge. Of those with nonwalking FIM scores (1-5) on admission,
56% were using wheelchairs at discharge. Multivariate analyses revealed that the
adjusted odds ratios of using a wheelchair (manual or powered) were 3.33 (95%
confidence interval [CI], 1.33-8.33) for those with left-hemisphere versus
right-hemisphere strokes (P=.010), .94 (CI, .91-.96) for each point rise in the
total raw FIM score on admission (P<.0001), and 19.46 (CI, 6.33-59.81) if the
total admission FIM score was less than 80 versus greater than or equal to 80
(P<.0001). CONCLUSIONS: On discharge from our rehabilitation center, 40% of
people with stroke were using manual wheelchairs and 1% powered wheelchairs.
People who were not walking on admission, those with left-hemisphere strokes, and
those with lower total admission FIM scores were more likely to use a wheelchair.
These findings may permit clinicians to predict wheelchair use better early in
the rehabilitation process, when it can affect rehabilitation planning.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS