Physical fitness in persons with hemiparetic stroke: its structure and longitudinal changes during an inpatient rehabilitation programme.
OBJECTIVE
To test the hypothesis that the structure of fitness in patients with hemiparetic stroke can be categorized into impairment/disability, cardiopulmonary, muscular and metabolic domains, and to study longitudinal changes in their fitness during an inpatient rehabilitation programme.


METHODS
Structure analysis of multiple fitness parameters with principal component analysis (PCA), and a before and after trial.


METHODS
Tertiary rehabilitation centre in Japan.


METHODS
One hundred and seven consecutive inpatients with hemiparetic stroke.


METHODS
A conventional stroke rehabilitation programme consisting of 80 minutes of physical therapy and occupational therapy sessions five days a week, and daily rehabilitation nursing for a median duration of 105.5 days.


METHODS
Principal component scores extracted from measurement of paresis/daily living (the Stroke Impairment Assessment Set (SIAS) and the Functional Independence Measure (FIM)); muscular (grip strength (GS), knee extensor torque, and cross-sectional areas of thigh muscles); metabolic (body mass index (BMI) and fat accumulation on CT); cardiopulmonary (heart rate oxygen coefficient (HR-O2-Coeff) obtained with a graded bridging activity and a 12-minute propulsion distance).


RESULTS
PCA categorized the original 15 variables into four factors corresponding to paresis/activities of daily living, muscular, metabolic and cardiopulmonary domains, and explained 78.1% of the total variance at admission and 69.6% at discharge. Except the metabolic domain, PCA scores for the other three domains improved significantly at discharge (paired t-test, p < 0.05).


CONCLUSIONS
The hypothetical structure of fitness was confirmed, and the PCA scores were useful in following longitudinal changes of fitness during inpatient rehabilitation.
Tsuji
Tetsuya
T
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan. cxa01423@nifty.ne.jp
Liu
Meigen
M
Hase
Kimitaka
K
Masakado
Yoshihisa
Y
Takahashi
Hidetoshi
H
Hara
Yukihiro
Y
Chino
Naoichi
N
D000328:Adult; D000368:Aged; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009788:Occupational Therapy; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D020521:Stroke / Q000145:classification / Q000150:complications; D000071939:Stroke Rehabilitation