# IDENTIFYING PROFILES OF STROKE PATIENTS BENEFITTING FROM ADDITIONAL TRAINING: A LATENT CLASS ANALYSIS APPROACH

## TL;DR

This study finds that stroke patients with right-side weakness and daily activity challenges benefit most from extra training, especially when combining hospital staff and self-exercise.

## Contribution

The study identifies specific stroke patient profiles that benefit from additional rehabilitation training using latent class analysis.

## Key findings

- Patients with right hemiparesis and modified dependence showed improved FIM scores with additional training.
- Combining self-exercise and hospital staff training led to significantly higher FIM gains compared to usual care.
- Latent class analysis revealed seven distinct patient profiles based on admission characteristics.

## Abstract

To identify profiles of stroke patient benefitting from additional training, using latent class analysis.

Retrospective observational study.

Patients with stroke (n = 6,875) admitted to 42 recovery rehabilitation units in Japan between January 2005 and March 2016 who were registered in the Japan Association of Rehabilitation Database.

The main outcome measure was the difference in Functional Independence Measure (FIM) scores between admission and discharge (referred to as “gain”). The effect of additional training, categorized as usual care (no additional training), self-exercise, training with hospital staff, or both exercise (combining self-exercise and training with hospital staff), was assessed through multiple regression analyses of latent classes.

Applying inclusion and exclusion criteria, 1185 patients were classified into 7 latent classes based on their admission characteristics (class size n = 82 (7%) to n = 226 (19%)). Patients with class 2 characteristics (right hemiparesis and modified dependence in the motor-FIM and cognitive-FIM) had positive FIM gain with additional training (95% confidence interval (95% CI) 0.49–3.29; p < 0.01). One-way analysis of variance revealed that training with hospital staff (95% CI 0.07–16.94; p < 0.05) and both exercises (95% CI 5.38–15.13; p < 0.01) led to a significantly higher mean FIM gain than after usual care.

Additional training in patients with stroke with right hemiparesis and modified dependence in activities of daily living was shown to improve activities of daily living. Training with hospital staff combined with self-exercise is a promising rehabilitation strategy for these patients.

LAY ABSTRACT

This study, conducted in Japan, aimed to identify the profiles of patients with stroke who would benefit from extra training. The records of 6875 patients with stroke who had been admitted to rehabilitation units between 2005 and 2016 were analysed and the change in patients’ abilities between admission to the unit and discharge was determined. Some patients received additional training, while others did not. The results showed that patients with certain characteristics, such as right-side weakness and difficulty with daily activities, improved with extra training. Specifically, a combination of training from hospital staff and self-exercise was most effective. In summary, the study found that additional training can help stroke patients, especially those with right-side weakness and those who find daily activities challenging. Combining training from hospital staff with self-exercise seems to be a promising approach for rehabilitation in these patients.