Relationship between behavioural observational rating scale of attention function and toileting ability in patients with acute stroke: A cross-sectional study

Introduction: Toileting independence is a key factor influencing discharge to home for patients with stroke and is a primary target in rehabilitation. Achieving toileting independence requires multiple physical and cognitive functions, including attention. Attentional deficits, occurring in up to 80% of stroke survivors, may hinder toileting independence; however, their impact has not been systematically examined using standardised behavioural observation scales such as the Moss Attention Rating Scale (MARS). We aimed to investigate the relationship between MARS scores and the degree of toileting independence in patients with acute stroke. Method: This cross-sectional study included 61 Japanese patients with stroke (44 with cerebral infarctions, 4 with cerebral haemorrhages and 13 with subarachnoid haemorrhages). The primary outcomes were toileting and toilet trans scores of the Functional Independence Measure. The secondary outcomes were MARS scores, grip strength and Trail Making Test scores. Results: Ordinal logistic regression analysis indicated that MARS scores were independently associated with the degree of toileting independence ( R 2 > 0.50, p < 0.05). Conclusion: Toileting independence relies on physical and cognitive functions. The MARS is valuable for determining toileting independence. Using behavioural observation scales, such as the MARS, along with neurological and neuropsychological tests may further support the establishment of occupational therapy goals and interventions.