Participation in Rehabilitation and Activities of Daily Living at Hospital Admission as Predictors of Post-Stroke Improvement in ADL: A Retrospective Cohort Study.

Background: Most measures of rehabilitation participation rely on self-report, excluding patients with cognitive impairment or aphasia. The observational Pittsburgh Rehabilitation Participation Scale (PRPS) allows their inclusion; however, whether rehabilitation participation assessed using the PRPS...

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Published in:NeuroRehabilitation Vol. 59; no. 1; pp. 108 - 119
Main Authors: Kawakami, Kenji, Tanabe, Shigeo, Omatsu, Sayaka, Kinoshita, Daiki, Kitabatake, Ryo, Koshisaki, Hiroo, Fujimura, Kenta, Kanada, Yoshikiyo, Sakurai, Hiroaki
Format: research tables/charts Journal Article
Published: Sage Publications Inc. Aug2026
Online Access:View this record in EBSCOhost
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      dt: Aug2026
      vid: 59
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Participation in Rehabilitation and Activities of Daily Living at Hospital Admission as Predictors of Post-Stroke Improvement in ADL: A Retrospective Cohort Study.
      aug:
        au:
          Kawakami, Kenji
          Tanabe, Shigeo
          Omatsu, Sayaka
          Kinoshita, Daiki
          Kitabatake, Ryo
          Koshisaki, Hiroo
          Fujimura, Kenta
          Kanada, Yoshikiyo
          Sakurai, Hiroaki
        affil: Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake-shi, Aichi, Japan
      sug:
        subj:
          Stroke Rehabilitation
          Patient Participation Evaluation
          Activities of Daily Living
          Recovery
          Functional Status
          Cognition Disorders Rehabilitation
          Aphasia Rehabilitation
          Human
          Japan
          Male
          Female
          Aged
          Aged, 80 and Over
          Retrospective Design
          Record Review
          Prospective Studies
          Scales
          Descriptive Statistics
          Data Analysis Software
          Multiple Regression
          Confidence Intervals
          Rasch Analysis
          Patient Admission
          Survivors
          Occupational Therapy
          Functional Assessment
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: Most measures of rehabilitation participation rely on self-report, excluding patients with cognitive impairment or aphasia. The observational Pittsburgh Rehabilitation Participation Scale (PRPS) allows their inclusion; however, whether rehabilitation participation assessed using the PRPS modifies improvement in activities of daily living (ADL) remains unclear. Objective: To determine whether rehabilitation participation assessed using the PRPS modifies the association between baseline ADL and subsequent improvement after stroke. Methods: This retrospective cohort study included 137 stroke survivors in a subacute rehabilitation ward. Admission rehabilitation participation was assessed by the PRPS. ADL improvement was evaluated using the Functional Independence Measure (FIM) motor effectiveness score. Hierarchical multiple regression analysis included age, days from onset to hospital admission, admission FIM motor and cognitive scores, and admission PRPS score in Step 1, followed by the PRPS × admission FIM motor interaction term in Step 2. Prediction plots were generated for each PRPS score. Results: The median admission PRPS and FIM motor effectiveness scores were 5 (interquartile range [IQR], 4–6) and 0.70 (IQR, 0.33–0.88), respectively. Adding the PRPS × FIM motor interaction term in Step 2 significantly improved the model fit (ΔR2 = 0.057, ΔF(1,130) = 16.28, p <.001), resulting in a final model (R2 = 0.545, p <.001). Prediction plots showed steeper slopes with higher PRPS scores. Conclusions: Admission rehabilitation participation assessed by the PRPS modified the association between baseline ADL and ADL improvement. Observable participation should be interpreted in relation to baseline motor ADL rather than in isolation. Lower participation may indicate a need for additional clinical support.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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