Factors Influencing Home Modification of Stroke Patients
Wutichai Permsirivanich MD*, Suttipong Tipchatyotin MD*, Krisna Piravej MD**, Uma Juntawises MSN***, Vilai Kuptniratsaikul MD****, Arinda Ma-A-Lee MSc*****
Affiliation : * Rehabilitation Medicine Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand ** Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand *** Songklanagarind Hospital, Songkhla, Thailand **** Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ***** Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Background : Home modification for stroke victims is often necessary to prevent falls and enable them to
have a better quality of life. Up-to-date relationship between personal factors and home modifications in
post-stroke patients has not been investigated.
Objective : To identify significant personal factors influencing the requirement for home modification in
post-stroke patients.
Study design: Prospective, analytical study.
Material and Method: Two hundred eighty one post-stroke patients were recruited from nine tertiary
rehabilitation centers in Thailand. All patients received inpatient rehabilitation programs until either they
reached the rehabilitation goals or registered two consecutive stable weeks as measured by their Barthel
index score. Personal factors related to home modification were assessed at study entry, during hospital stay
and at discharge. The correlation between personal factors and necessities of home modification in
post-stroke patients were reported through univariate and multivariate modeling.
Results : The results of univariate analysis showed that a low Barthel index score (< 14/20) (at baseline and
discharge), low Brunnstrom stage of arm or leg (< IV/VI) at baseline, and intolerance to intensive rehabilitation
programs (< 3 hr/day) indicated a necessity for modifications in the patient’s home (p < 0.05). The results of
multivariate modeling showed that a low Barthel index score (at baseline and discharge), and intolerance to
intensive rehabilitation were significant predictors of a requirement for home modification (p < 0.05).
Conclusion : A low level of physical functioning and intolerance to intensive rehabilitation are significant
predictors for the necessity of home modifications in stroke victims.
Keywords : Stroke, Home modification, Factor
