Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.
Basel Mobility Center, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland.
J Neurol. 2023 Aug;270(8):3992-4003. doi: 10.1007/s00415-023-11748-5. Epub 2023 May 4.
Life-space mobility is defined as the size of the area in which a person moves about within a specified period of time. Our study aimed to characterize life-space mobility, identify factors associated with its course, and detect typical trajectories in the first year after ischemic stroke.
MOBITEC-Stroke (ISRCTN85999967; 13/08/2020) was a cohort study with assessments performed 3, 6, 9 and 12 months after stroke onset. We applied linear mixed effects models (LMMs) with life-space mobility (Life-Space Assessment; LSA) as outcome and time point, sex, age, pre-stroke mobility limitation, stroke severity (National Institutes of Health Stroke Scale; NIHSS), modified Rankin Scale, comorbidities, neighborhood characteristics, availability of a car, Falls Efficacy Scale-International (FES-I), and lower extremity physical function (log-transformed timed up-and-go; TUG) as independent variables. We elucidated typical trajectories of LSA by latent class growth analysis (LCGA) and performed univariate tests for differences between classes.
In 59 participants (mean age 71.6, SD 10.0 years; 33.9% women), mean LSA at 3 months was 69.3 (SD 27.3). LMMs revealed evidence (p ≤ 0.05) that pre-stroke mobility limitation, NIHSS, comorbidities, and FES-I were independently associated with the course of LSA; there was no evidence for a significant effect of time point. LCGA revealed three classes: "low stable", "average stable", and "high increasing". Classes differed with regard to LSA starting value, pre-stroke mobility limitation, FES-I, and log-transformed TUG time.
Routinely assessing LSA starting value, pre-stroke mobility limitation, and FES-I may help clinicians identify patients at increased risk of failure to improve LSA.
生活空间移动能力被定义为一个人在特定时间段内在特定区域内移动的范围。我们的研究旨在描述生活空间移动能力，确定与生活空间移动能力变化相关的因素，并在缺血性中风后第一年检测典型轨迹。
MOBITEC-Stroke（ISRCTN85999967；13/08/2020）是一项队列研究，在中风发作后 3、6、9 和 12 个月进行评估。我们应用线性混合效应模型（LMM），以生活空间移动能力（生活空间评估；LSA）作为结果，以时间点、性别、年龄、中风前移动能力受限、中风严重程度（国立卫生研究院中风量表；NIHSS）、改良Rankin量表、合并症、邻里特征、是否有车、跌倒效能量表-国际（FES-I）和下肢体能（对数转换计时起立行走；TUG）作为独立变量。我们通过潜在类别增长分析（LCGA）阐明了 LSA 的典型轨迹，并对不同类别的差异进行了单变量检验。
在 59 名参与者（平均年龄 71.6±10.0 岁；33.9%为女性）中，3 个月时的平均 LSA 为 69.3（27.3）。LMM 显示，中风前移动能力受限、NIHSS、合并症和 FES-I 与 LSA 的变化独立相关（p≤0.05）；时间点无显著影响的证据。LCGA 揭示了三个类别：“低稳定”、“平均稳定”和“高增加”。这些类别在 LSA 起始值、中风前移动能力受限、FES-I 和对数转换 TUG 时间方面存在差异。
常规评估 LSA 的起始值、中风前移动能力受限和 FES-I 可能有助于临床医生识别 LSA 改善失败风险增加的患者。
