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Maximum walking speed is a key determinant of long distance walking function after stroke
Louis N Awad1, Darcy S Reisman1, Tamara R Wright2
1Department of Physical Therapy, University of Delaware, Newark, Delaware Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware.
Topics in Stroke Rehabilitation
|December 4, 2014
Summary
Improving maximum walking speed is key for individuals with chronic stroke to enhance their long-distance walking function. This study found that other factors, like balance, were not significant predictors when maximum walking speed was considered.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Persistent walking dysfunction after stroke rehabilitation highlights the need for targeted interventions.
- Current rehabilitation strategies struggle to identify modifiable deficits that directly improve walking function.
- Previous studies overlooked the crucial role of maximum walking speed as a covariate in identifying key deficits.
Purpose of the Study:
- To investigate the relationship between common poststroke variables and long-distance walking function.
- To determine if these relationships persist when controlling for maximum walking speed.
- To identify the most critical factor for improving long-distance walking poststroke.
Main Methods:
- Cross-sectional correlation analyses were performed on data from 57 individuals in the chronic stroke phase (≥6 months poststroke).
- Key variables assessed included standing balance, walking balance, balance self-efficacy, lower extremity motor function, and maximum walking speed.
- A subgroup analysis examined the relationship between changes in maximum walking speed and changes in long-distance walking function after training.
Main Results:
- All measured variables initially showed strong correlations with long-distance walking function (r values from 0.448 to 0.900).
- However, after controlling for maximum walking speed, none of the other variables remained significantly related to long-distance walking function.
- Maximum walking speed, conversely, remained highly related to long-distance walking function even when other variables were controlled. Changes in maximum walking speed strongly predicted changes in long-distance walking function (r = 0.737).
Conclusions:
- Maximum walking speed is a critical determinant of long-distance walking function in individuals with chronic stroke.
- Interventions aimed at increasing maximum walking speed may be essential for improving overall walking ability and endurance.
- Future rehabilitation efforts should prioritize enhancing maximum walking speed to achieve better functional recovery.
