Application of hurdle model with random effects for evaluating the balance improvement in stroke patients.

Alireza Akbarzadeh Baghban, Somayeh Ahmadi Gooraji, Amir Kavousi, Navid Mirzakhani Araghi

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Article in Medical journal of the Islamic Republic of Iran, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Alireza Akbarzadeh BaghbanAssociate Professor of Biostatistics, Department of Basic Sciences, Faculty of rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Akbarzad@sbmu.ac.ir.

Somayeh Ahmadi GoorajiMSc of Biostatistics, Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Ahmadisomayeh90@gmail.com.

Amir KavousiAssistant Professor of Statistics, Department of Basic Sciences, Faculty of Health Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Kavousi@sbmu.ac.ir.

Navid Mirzakhani AraghiMSc of Occupational therapy, Department of Occupational Therapy, Faculty of rehabilitation sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mirzakhany@yahoo.com.

Funding

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6 · The paper itself

Abstract

backgroundStroke is a prevalent cause of disability in adults. The fall is the most common balance and motor impairments, which affects the quality of life in stroke patients. This study aims to employ random effects hurdle model for evaluating the balance improvement in stroke patients under the occupational therapy.

methodsIn this longitudinal study with repeated measurement during one year between 2013 and 2014, the data was collected using non-random sampling method from three occupational therapy clinics. For a total of 38 stroke patients, the number of falls was recorded every two weeks. The random effects hurdle model and random effects zero inflated Poisson (ZIP) model were fitted to the data and were compared together. Data analysis was carried out using SAS Software version 9.2.

resultsThe results of random effects ZIP model showed that the covariates of sex and age and affected side of stroke and follow up duration had statistically significant effect on balance improvement (p< 0.05). The occupational therapy has been effective on balance improvement more than 40% during one year.

conclusionThe ZIP model with random effects can capture zero inflation and correlation structure in longitudinal count data simultaneously. Older patients, women and patients with left-side impairments were more at risk of fall and balance impairment, so they need more care and therapy.

Indexed as

BalanceOccupational therapyStroke

Identifiers

PMID26793635

PMCPMC4715396

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