Mobility assistive device utilization in a prospective study of patients with first-ever stroke

Objective: To estimate the extent to which clinical and functional features of stroke were related to the use of mobility assistive technology devices. Design: Longitudinal study of quality of life after stroke. Setting: Hospitals, rehabilitation centers, and universities in Ontario and Quebec. Participants: Subjects (N=316) with confirmed initial stroke were included in this analysis. Fifty-eight percent of the overall sample were men (n=184). The mean age of this sample at the time of the stroke +/- standard deviation was 65.3 +/- 15.3 years (range, 19-96y). One hundred thirty-five patients received a mobility assistive device poststroke, and 181 did not. Intervention: Assistive devices for mobility (canes, walkers, wheelchairs). Main Outcome Measures: Assistive device use and mobility capacity. Results: Mobility device nonusers were less physically disabled than device users on a variety of measures. Poor physical functioning but good cognition were reliably associated with mobility device use. Use of multiple mobility assistive devices was more often associated with poorer physical functioning than was single device use. For single device users, wheelchair use was predicted by cognition, functional independence, and stroke recovery. Cane users, compared with walker users, had better mobility and were less physically impaired by stroke. Conclusions: Patients were well matched to device type based on their mobility capacity. The findings of this study suggest that assistive device prescription-outcome relationships in stroke can be effectively and meaningfully modeled.