Predictors of change in quality of life after distributed constraint-induced therapy in patients with chronic stroke.
BACKGROUND
There are no reports of predictive models or predictors for quality of life (QoL) after constraint-induced therapy (CIT).


OBJECTIVE
This investigation identified predictors of change in stroke-related QoL after distributed CIT using the Chi-squared Automatic Interaction Detector (CHAID) method.


METHODS
A total of 58 patients with chronic stroke were treated with CIT for 2 hours daily for 3 weeks. The 7 potential predictors were age, gender, side of lesion, time since stroke, cognitive status, motor impairment of upper extremity, and activities of daily living (ADL). QoL was measured by the Stroke Impact Scale (SIS). CHAID analysis was used to examine for associations between the 7 predictors and each SIS domain. The validity of each model generated by the analysis was evaluated.


RESULTS
Daily functional performance as measured by the Functional Independence Measure (FIM) was found to determine SIS outcomes, including overall score (P = .006) and the ADL/instrumental ADL (IADL) domain (P = .004). None of the potential predictors emerged as significant predictors of the strength, memory, emotion, communication, mobility, hand function, and participation domains of SIS. The misclassification risk estimates were small, indicating good validity for the CHAID models.


CONCLUSIONS
The functional independence score of the FIM can predict the overall SIS score as well as the ADL/IADL domain of the SIS in chronic stroke patients who receive CIT, but larger databases are needed to confirm this. CHAID analysis was a useful approach for an exploratory study.
Huang
Yan-hua
YH
Department of Occupational Therapy, School of Health and Human Services, College of Professional Studies, California State University, Dominguez Hills, CA, USA.
Wu
Ching-yi
CY
Hsieh
Yu-wei
YW
Lin
Keh-chung
KC
D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D000368:Aged; D001132:Arm / Q000294:innervation / Q000503:physiopathology; D002908:Chronic Disease; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010291:Paresis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D010809:Physical Fitness / Q000523:psychology; D026741:Physical Therapy Modalities; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology*; D012149:Restraint, Physical / Q000379:methods*; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation