Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study

Objective: To determine the time course of longitudinal changes in the independence level of toileting-related subtasks in post-stroke patients. Design: Single-institution, prospective cohort study. Subjects/Patients: A total of 101 consecutive patients with stroke admitted to subacute rehabilitat...

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Main Authors: Shin Kitamura, Yohei Otaka, Shintaro Uehara, Yudai Murayama, Kazuki Ushizawa, Yuya Narita, Naho Nakatsukasa, Daisuke Matsuura, Rieko Osu, Kunitsugu Kondo, Sachiko Sakata
Format: Article
Language:English
Published: Medical Journals Sweden 2025-05-01
Series:Journal of Rehabilitation Medicine
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Online Access:https://medicaljournalssweden.se/jrm/article/view/42390
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Summary:Objective: To determine the time course of longitudinal changes in the independence level of toileting-related subtasks in post-stroke patients. Design: Single-institution, prospective cohort study. Subjects/Patients: A total of 101 consecutive patients with stroke admitted to subacute rehabilitation wards who urinated/defecated in bathrooms using wheelchairs upon admission. Methods: Occupational therapists assessed the independence level of patients in each of the 24 toileting subtasks on a 3-level rating scale using the Toileting Tasks Assessment Form every 2–4 weeks from admission to the endpoint (achieving independent toileting or discharge). Patients were classified based on admission and endpoint assessment form scores using a two-step cluster analysis. Results: Patients were classified into Cluster 1 (30 patients who exhibited a greater independence level in all subtasks upon admission [46.7–100% of patients performed each subtask independently] to the endpoint [73.3–100%]), Cluster 2 (41 patients who showed less independence upon admission [0–26.8%] but gained greater independence at the endpoint [34.1–73.2%]), and Cluster 3 (30 patients whose independence levels remained low in many subtasks from admission [0–26.7%] to the endpoint [3.3–26.7%]). Conclusion: Changes in toileting independence levels could be classified into 3 time courses. Effective intervention strategies may differ between each group.
ISSN:1651-2081