Influence of Body Functions and Structures on Home Return Through Activity and Participation: A Mediation Analysis in Patients With Stroke.

OBJECTIVE: This study aimed to examine whether body function and structure directly influences discharge home or exerts an indirect effect via activity and participation in patients with stroke, employing mediation analysis. METHODS: Sixty-seven inpatients with stroke in a convalescent rehabilitation ward were retrospectively examined. Latent variables for body function and structure (grip strength, knee extension strength, six-minute walk test, Berg Balance Scale) and activity and participation (13 motor items from the Functional Independence Measure) were developed. Structural equation modeling assessed associations with home return. RESULTS: The direct effect of body function and structure on home return was not significant (β = 0.474, p = 0.0786). In contrast, the indirect effect via activity and participation was significant (β = -0.866, p = 0.001). CONCLUSION: Enhancement of body function alone does not sufficiently promote home return in patients with stroke. Improving activity and participation is vital for effective discharge planning, underscoring the essential role of occupational therapy in rehabilitation.