Objective: To examine the utility of decision analysis methods for examining the dynamic nature of impairment-activity interactions following stroke.
Design: Decision analyses (Chi-squared Automatic Interaction Detector) of a prospective cohort study.
Setting: Community and institutional settings based on the location of participants three months after stroke.
Participants: Individuals were recruited from consecutive admissions to a regional academic health center and were assessed three months after stroke (N=67).
Main outcome measures: Neurological impairment was measured with the National Institutes of Health Stroke Scale (NIHSS). Mobility, self-care and instrumental activities of daily living (instrumental ADL) performance were assessed with a performance observation measure, the Performance Assessment of Self-care Skills (PASS). Decision analysis methods were used to examine interactions between neurological impairments and activity outcomes.
Results: Unique neurological impairments were associated with each activity outcome (bowel and bladder urgency interacted with mobility; hand function interacted with self-care; mental functions interacted with instrumental ADL), and these findings are supported by previous studies. The predictive validity of mobility and self-care analyses was stronger than the instrumental ADL analyses.
Conclusions: Decision analysis methods show promise for understanding dynamic impairment-activity interactions. This understanding may enhance methods for informing rehabilitation decisions.
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