Clinical and biomechanical factors which predict timed up and down stairs test performance in hemiparetic patients

The ability to ascend and descend a flight of stairs is considered as one of the best predictors of free-living activity and is correlated with domestic extrinsic activity in hemiparetic patients. However, the relationship between timed-stair performance and clinical and biomechanical parameters has never been studied this population. The aim of this study was to determine if performance on the Timed Up and Down Stairs (TUDS) test was related to clinical variables (maximal gait speed, strength and spasticity) and to biomechanical gait parameters (spatio-temporal, kinematic and kinetic gait parameters) in hemiparetic patients.

Sixty hemiparetic patients performed the TUDS test, underwent 3D gait-analysis and a clinical assessment. Pearson's correlations and two stepwise multiple linear regression analyses were carried out to identify the parameters which were the most highly correlated with TUDS test performance among the clinical variables and gait parameters on the paretic side.

Maximal walking speed on the 10-m walk test and strength of the ankle dorsiflexors were the clinical variables that were the most related to TUDS test performance (63% of variance explained). The percentage of single support phase on the paretic side was the biomechanical gait parameter which was the most related to TUDS test performance (58% of variance explained).

The results of this study identified three parameters which predicted the performance to ascend and descend a flight of stairs as fast as possible in hemiparetic patients. Rehabilitation programs which aim to improve stair performance and independence in daily life activities should focus on these three parameters.