Factors Influencing the Effectiveness of Motor Functional Independence Measure in Patients with Heart Failure Admitted to a Convalescent Rehabilitation Unit

Yuki Kimura, Hidetaka Furuya, Hidehiko Kashiwagi, Hidenori Watanabe
Purpose:

This study aimed to investigate the factors affecting the effectiveness of M-FIM in patients with heart failure who were admitted to a convalescent rehabilitation unit.

Methods:

This retrospective cohort study included patients with heart failure aged ≥65 years, admitted to a recovery unit. We investigated age, sex, body mass index, medical history, medication history, classification of cardiac insufficiency (reduced or preserved ejection fraction), grip strength ratio, GNRI, FIM, and length of hospital stay. M-FIM was used as an index of improvement in activities of daily living. It was calculated as (discharge M-FIM-admission M-FIM) / (maximum possible M-FIM-admission M-FIM), with the first quartile defined as poor functional recovery. Grip strength ratios were calculated for males (28 kg) and females (18 kg) according to the sarcopenia definition by the Asian Working Group for Sarcopenia. Logistic regression analysis was used to examine factors affecting the effectiveness of M-FIM. Factors extracted by logistic regression analysis were calculated as cutoff values using receiver operating characteristic curves based on poor functional recovery. Finally, logistic regression was performed to confirm whether the categorical variables were extracted as factors based on the cutoff values.

Results:

The mean age of the study participants was 82.0 ± 8.4 years, and 40（48% of the participants were males. Logistic regression analysis revealed the grip strength ratio (cutoff, p-value, odds ratio: 0.51, 0.04, and 0.01, respectively) and cognitive FIM (cutoff, p-value, odds ratio: 17.5, 0.03, and 0.69, respectively). Categorical grip strength ratios (p=0.01, odds ratio: 19.2) and cognitive FIM (p=0.01, odds ratio: 7.4) were also determined.

Conclusion(s):

The study results suggest that patients with heart failure with a grip strength ratio of 0.51 (absolute value: 15 kg in males and 10 kg in females) and a cognitive FIM score of 17.5 may have poor effectiveness of M-FIM.

Implications:

We believe that these values can be used to predict the prognosis of patients with heart failure admitted to a convalescent rehabilitation unit. It is necessary to screen patients at the time of admission and take countermeasures at an early stage using this standard as a reference.

Funding acknowledgements:
No grant support.
Keywords:
Heart Failure
Activities of Daily Living
Convalescent Rehabilitation Unit
Primary topic:
Disability and rehabilitation
Second topic:
Older people
Third topic:
Cardiorespiratory
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Sonodakai Ethical Review Committee
Provide the ethics approval number:
No. 156
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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