OBJECTIVE To examine the odds of persons with stroke achieving minimal clinically important difference (MCID) in functional independence during inpatient rehabilitation relative to cognitive impairment (CI) severity, site, and rehabilitation teams' exposure to a Cognitive Orientation to daily Occupational Performance (CO-OP) knowledge translation (KT) intervention DESIGN: A pre-post observational study was conducted using data from a centralized referral system. Our research team implemented a CO-OP KT intervention as part of a larger study aimed at training teams to use the CO-OP approach. SETTING Five inpatient rehabilitation units. PARTICIPANTS Cases extracted from a centralized referral system from the five participating units. INTERVENTIONS Not Applicable MAIN OUTCOME MEASURES: The FIM™ instrument data from twelve months pre-intervention and 6 months post-intervention were analyzed. A logistic regression was performed to determine the odds ratios for achieving MCID based on sample cohort (historical control not exposed to CO-OP KT versus post CO-OP KT intervention), controlling for site and severity of CI. RESULTS A model that considered the intervention, admission score, CI severity, and site was the best fit for the cases analyzed. Those with Severe CI were less likely to achieve FIM Total MCID compared to those with no CI (p=<.001; OR=.18; Confidence Interval .09-.39). Taking site and CI into account, cases post CO-OP KT intervention were significantly more likely to achieve MCID on FIM™ Motor (p=.048; OR=1.4; Confidence Interval 1.00-1.98) than historical controls. CONCLUSION The CO-OP KT intervention is associated with increased odds of achieving MCID in the FIM™ Motor subscale in inpatient stroke rehabilitation.

中文翻译：

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知识翻译干预后功能独立性的最小临床重要差异

目的 研究卒中患者在住院康复期间在功能独立性方面实现最小临床重要差异 (MCID) 的几率与认知障碍 (CI) 严重程度、部位和康复团队对日常职业表现 (CO- OP) 知识翻译 (KT) 干预设计：使用来自中央转诊系统的数据进行了一项前后观察性研究。我们的研究团队实施了 CO-OP KT 干预，作为旨在培训团队使用 CO-OP 方法的更大研究的一部分。设置五个住院康复单位。参与者 从五个参与单位的集中转诊系统中提取的病例。干预措施 不适用 主要结局指标：分析了干预前 12 个月和干预后 6 个月的 FIM™ 仪器数据。进行逻辑回归以确定基于样本队列（未暴露于 CO-OP KT 的历史对照与 CO-OP KT 干预后的干预）实现 MCID 的比值比，控制 CI 的部位和严重程度。结果 考虑了干预、入院评分、CI 严重程度和部位的模型最适合所分析的病例。与没有 CI 的人相比，有严重 CI 的人不太可能达到 FIM 总 MCID（p=<.001；OR=.18；置信区间 0.09-.39）。考虑到站点和 CI，CO-OP KT 干预后的病例比历史对照更有可能在 FIM™ 电机上实现 MCID（p=.048；OR=1.4；置信区间 1.00-1.98）。