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Related Experiment Videos

Predicting improvement in gait after stroke: a longitudinal prospective study.

Boudewijn Kollen1, Ingrid van de Port, Eline Lindeman

  • 1Research Bureau, Isala klinieken, Zwolle, The Netherlands.

Stroke
|November 12, 2005
PubMed
Summary

Improvement in standing balance and reduced inattention are key to better walking ability after stroke. Leg strength is less critical, and gains are most significant early in recovery.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Biostatistics

Background:

  • Stroke significantly impacts functional ambulation, necessitating research into recovery predictors.
  • Understanding longitudinal changes in walking ability is crucial for effective post-stroke rehabilitation.

Purpose of the Study:

  • To investigate the longitudinal relationship between changes in walking ability and time-dependent covariates.
  • To develop a multivariate regression model for predicting longitudinal changes in walking ability post-stroke.

Main Methods:

  • A prospective cohort study of 101 acute ischemic stroke patients with 18 repeated measurements over the first post-stroke year.
  • Assessed functional ambulation categories (FAC), Fugl-Meyer leg score (FM-leg), Motricity index leg score (MI-leg), letter cancellation task (LCT), Fugl-Meyer balance (FM-balance), and timed balance test (TBT).

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  • Intervention included a basic rehabilitation program with additional limb or splint therapy.

    • Main Results:

    • Regression analysis of 1532 change scores revealed timed balance test (TBT) improvements as the strongest predictor of FAC improvement (beta=0.094; P<0.001).
    • Improvements in FM-leg (beta=0.014; P<0.001), reduced LCT omissions (beta=-0.010; P<0.001), and MI leg test (beta=0.001; P<0.001) also predicted better walking ability.
    • Time was negatively associated with improvement (beta=-0.002; P<0.001), indicating earlier gains are more substantial.

    Conclusions:

    • Enhanced standing balance control is more influential than leg strength for improving walking ability post-stroke.
    • Reduced visuospatial inattention independently correlates with gait improvement.
    • The negative association with time suggests that the most significant recovery in walking ability occurs early after stroke.