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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author Shin Kitamura
Yohei Otaka
Shintaro Uehara
Yudai Murayama
Kazuki Ushizawa
Yuya Narita
Naho Nakatsukasa
Daisuke Matsuura
Rieko Osu
Kunitsugu Kondo
Sachiko Sakata
author_facet Shin Kitamura
Yohei Otaka
Shintaro Uehara
Yudai Murayama
Kazuki Ushizawa
Yuya Narita
Naho Nakatsukasa
Daisuke Matsuura
Rieko Osu
Kunitsugu Kondo
Sachiko Sakata
author_sort Shin Kitamura
collection DOAJ
description 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.
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spelling doaj-art-e72e7341afc8426198445f2f29caf5082025-08-20T01:54:04ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812025-05-015710.2340/jrm.v57.42390Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort studyShin Kitamura0https://orcid.org/0000-0002-4442-0854Yohei Otaka1https://orcid.org/0000-0002-6797-2782Shintaro Uehara2https://orcid.org/0000-0002-6255-1815Yudai Murayama3Kazuki Ushizawa4Yuya Narita5Naho Nakatsukasa6Daisuke Matsuura7Rieko Osu8Kunitsugu Kondo9Sachiko Sakata10Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan; Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Aichi, Japan1Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Aichi, JapanFaculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, JapanDepartment of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan1Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Aichi, JapanDepartment of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Chiba Prefectural University of Health Sciences, Chiba, JapanDepartment of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan1Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Aichi, JapanFaculty of Human Sciences, Waseda University, Saitama, JapanDepartment of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, JapanDepartment of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, JapanObjective: 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. https://medicaljournalssweden.se/jrm/article/view/42390activities of daily livingcerebrovascular disorderscluster analysistask performancewheelchair
spellingShingle Shin Kitamura
Yohei Otaka
Shintaro Uehara
Yudai Murayama
Kazuki Ushizawa
Yuya Narita
Naho Nakatsukasa
Daisuke Matsuura
Rieko Osu
Kunitsugu Kondo
Sachiko Sakata
Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study
Journal of Rehabilitation Medicine
activities of daily living
cerebrovascular disorders
cluster analysis
task performance
wheelchair
title Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study
title_full Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study
title_fullStr Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study
title_full_unstemmed Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study
title_short Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study
title_sort time course for acquiring toileting independence in patients with subacute stroke a prospective cohort study
topic activities of daily living
cerebrovascular disorders
cluster analysis
task performance
wheelchair
url https://medicaljournalssweden.se/jrm/article/view/42390
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