Predictors of Enrollment in an Exercise Study Among Stroke Survivors

Persistent Link:
http://hdl.handle.net/10150/271617
Title:
Predictors of Enrollment in an Exercise Study Among Stroke Survivors
Author:
Keller, Mallory Leigh
Issue Date:
2012
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Background: Stroke is the fourth leading cause of death in the United States and major contributor to physical and cognitive disability among the older adult population. Exercise is an important aspect of stroke rehabilitation to reduce disability. Objective: To determine if functional disability, physical function, cognitive impairment, age or gender are predictive of enrollment in an exercise study among stroke survivors. Methods: Cross-sectional design using data from stroke survivors (n=166) who consented to be screened for the “Tai Chi for Stroke Survivors Study.” All participants completed a brief survey to determine eligibility, prior to screening. Screening tests include the Modified Rankin Scale (mRS, functional disability), Short Physical Performance Battery (SPPB, physical function), and Mini-Mental Status Exam (MMSE, cognitive function). First, we conducted binary logistic regression using mRS, SPPB-balance, gait speed and leg strength test times, MMSE, age and gender, as single predictors of study enrollment. Then, multiple logistic regression using significant predictors determined the overall model. Results: Participants (n=166) were 69±11 years old, and reported mild-moderate disability (mRS=2.0±0.8), had some impairments in physical functioning (SPPB=7.0±2.6), diminished leg strength (5-timed chair stands=19.3±7.2 seconds), and slow gait speed (0.76±0.3 meters/second) but, were without cognitive impairments (MMSE=27.8±3.3). Significant predictors of study enrollment were leg strength [X²(1)= 16.37, p<0.01] and gait speed [X²(1)= 6.89, p<0.01]. Multiple logistic regression indicated that leg strength and gait speed together were predictive of enrollment [X² (2)=22.38, p<0.01]. Prediction success was 77%. Leg strength was a significant predictor in the model (Wald=6.2, p=0.01), indicating that as test completion time increases, the odds of enrollment increases [Exp(B)=1.12, Cl=1.03-1.23]. Gait speed was significant predictor in the model (Wald=5.6, p=0.02), indicating that as gait speed increases, the odds of enrollment decreases [Exp(B)=0.14, Cl=0.03-0.71]. A total of 60% (100/166) of screened participants (women=46/100) enrolled in our study. Conclusion: Physical function has been shown to predict disability and overall decline in health and well-being in stroke survivors with mild-moderate disability. The SPPB is simple to administer, taking 5-10 minutes to complete. This test readily identified stroke survivors with diminished leg strength and slower gait speed, and was predictive of enrollment into the exercise study.*
Type:
text; Electronic Thesis
Degree Name:
B.S.N.
Degree Level:
bachelors
Degree Program:
Honors College; Nursing
Degree Grantor:
University of Arizona

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titlePredictors of Enrollment in an Exercise Study Among Stroke Survivorsen_US
dc.creatorKeller, Mallory Leighen_US
dc.contributor.authorKeller, Mallory Leighen_US
dc.date.issued2012-
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractBackground: Stroke is the fourth leading cause of death in the United States and major contributor to physical and cognitive disability among the older adult population. Exercise is an important aspect of stroke rehabilitation to reduce disability. Objective: To determine if functional disability, physical function, cognitive impairment, age or gender are predictive of enrollment in an exercise study among stroke survivors. Methods: Cross-sectional design using data from stroke survivors (n=166) who consented to be screened for the “Tai Chi for Stroke Survivors Study.” All participants completed a brief survey to determine eligibility, prior to screening. Screening tests include the Modified Rankin Scale (mRS, functional disability), Short Physical Performance Battery (SPPB, physical function), and Mini-Mental Status Exam (MMSE, cognitive function). First, we conducted binary logistic regression using mRS, SPPB-balance, gait speed and leg strength test times, MMSE, age and gender, as single predictors of study enrollment. Then, multiple logistic regression using significant predictors determined the overall model. Results: Participants (n=166) were 69±11 years old, and reported mild-moderate disability (mRS=2.0±0.8), had some impairments in physical functioning (SPPB=7.0±2.6), diminished leg strength (5-timed chair stands=19.3±7.2 seconds), and slow gait speed (0.76±0.3 meters/second) but, were without cognitive impairments (MMSE=27.8±3.3). Significant predictors of study enrollment were leg strength [X²(1)= 16.37, p<0.01] and gait speed [X²(1)= 6.89, p<0.01]. Multiple logistic regression indicated that leg strength and gait speed together were predictive of enrollment [X² (2)=22.38, p<0.01]. Prediction success was 77%. Leg strength was a significant predictor in the model (Wald=6.2, p=0.01), indicating that as test completion time increases, the odds of enrollment increases [Exp(B)=1.12, Cl=1.03-1.23]. Gait speed was significant predictor in the model (Wald=5.6, p=0.02), indicating that as gait speed increases, the odds of enrollment decreases [Exp(B)=0.14, Cl=0.03-0.71]. A total of 60% (100/166) of screened participants (women=46/100) enrolled in our study. Conclusion: Physical function has been shown to predict disability and overall decline in health and well-being in stroke survivors with mild-moderate disability. The SPPB is simple to administer, taking 5-10 minutes to complete. This test readily identified stroke survivors with diminished leg strength and slower gait speed, and was predictive of enrollment into the exercise study.*en_US
dc.typetexten_US
dc.typeElectronic Thesisen_US
thesis.degree.nameB.S.N.en_US
thesis.degree.levelbachelorsen_US
thesis.degree.disciplineHonors Collegeen_US
thesis.degree.disciplineNursingen_US
thesis.degree.grantorUniversity of Arizonaen_US
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