Yoshida Taiki, Otaka Yohei, Kitamura Shin, Ushizawa Kazuki, Kumagai Masashi, Yaeda Jun, Osu Rieko
Tokyo Bay Rehabilitation Hospital, Department of Rehabilitation Medicine, Chiba, Japan.
Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan.
Front Neurol. 2023 Jul 14;14:1185813. doi: 10.3389/fneur.2023.1185813. eCollection 2023.
The motivation for rehabilitation is important in encouraging stroke patients to participate in rehabilitation; however, its relationship with outcomes is not well known. In addition, changes in patient motivation during hospitalization have not been examined.
To examine the relationship between motivation and rehabilitation outcomes for subacute stroke patients and to investigate the changes in motivation.
Prospective cohort study.
Subacute rehabilitation hospital.
The study enrolled a consecutive sample of patients ( = 201) with stroke admitted to a subacute rehabilitation ward from October 2017 to March 2019.
The functional independence measure and motivation in stroke patients for rehabilitation scale was evaluated at admission; at one, two, and three months after admission; and at discharge. The effectiveness and efficiency of the functional independence measure were calculated as rehabilitation outcomes. The effect of motivation on outcomes and the change in motivation in stroke patients for rehabilitation scale scores over time were analyzed using a linear mixed model.
The median (interquartile range) converted motivation in stroke patients for rehabilitation scale scores (converted to a range of 0-100) at admission; one, two, and three months after admission; and discharge was 86 (76-95), 83 (77-94), 81 (74-95), 81 (71-93), and 84 (75-95), respectively. The median (interquartile range) of effectiveness and efficiency of the functional independence measure from admission to discharge was 0.82 (0.68-0.91) and 0.41 (0.30-0.59), respectively. Motivation in stroke patients for rehabilitation scale scores were not significantly associated with the effectiveness and efficiency of the functional independence measure ( > 0.05). Motivation in stroke patients for rehabilitation scale scores were significantly lower at two ( = -3.1, 95% confidence interval [-5.3, -0.9], = 0.005) and three ( = -4.4, 95% confidence interval [-7.3, -1.6], = 0.002) months after admission than at admission.
Motivation might not directly affect rehabilitation outcomes assessed by the functional independence measure. Furthermore, many participants remained highly motivated, although their motivation decreased at one or three months after admission.
Assumptions that rehabilitation is ineffective because of low motivation may not be correct. To examine the influence on outcomes, both motivation and daily activities should be considered.
康复动机对于鼓励中风患者参与康复治疗很重要；然而，其与康复结果之间的关系尚不明确。此外，住院期间患者动机的变化尚未得到研究。
研究亚急性中风患者的动机与康复结果之间的关系，并调查动机的变化情况。
前瞻性队列研究。
亚急性康复医院。
本研究纳入了2017年10月至2019年3月期间连续入住亚急性康复病房的中风患者样本（n = 201）。
在入院时、入院后1个月、2个月、3个月以及出院时，对中风患者的功能独立性测量和康复动机量表进行评估。将功能独立性测量的有效性和效率作为康复结果进行计算。使用线性混合模型分析动机对结果的影响以及中风患者康复动机量表评分随时间的变化。
入院时、入院后1个月、2个月、3个月以及出院时，中风患者康复动机量表评分（转换为0 - 100分）的中位数（四分位间距）分别为86（76 - 95）、83（77 - 94）、81（74 - 95）、81（71 - 93）和84（75 - 95）。从入院到出院，功能独立性测量的有效性和效率的中位数（四分位间距）分别为0.82（0.68 - 0.91）和0.41（0.30 - 0.59）。中风患者康复动机量表评分与功能独立性测量的有效性和效率无显著相关性（P > 0.05）。入院后2个月（P = -3.1，95%置信区间[-5.3, -0.9]，P = 0.005）和3个月（P = -4.4，95%置信区间[-7.3, -1.6]，P = 0.002）时，中风患者康复动机量表评分显著低于入院时。
动机可能不会直接影响通过功能独立性测量评估的康复结果。此外，尽管许多参与者在入院后1个月或3个月时动机有所下降，但他们仍保持较高的积极性。
认为康复因动机低而无效的假设可能不正确。为了研究对结果的影响，应同时考虑动机和日常活动。
