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Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients
Published on: March 11, 2021
Assessment of Walking Speed and Distance Post-Stroke Increases After Providing a Theory-Based Toolkit
Nancy M Salbach1, Marilyn MacKay-Lyons, Jo-Anne Howe
1Departments of Physical Therapy (N.M.S., J.A.H., B.B.) and Medicine (M.T.B.), University of Toronto, Toronto, Canada; The KITE Research Institute, University Health Network, Toronto, Canada (N.M.S., J.A.H., M.T.B.); School of Physiotherapy, Dalhousie University, Halifax, Canada (M.M.L.); Nova Scotia Health Authority, Halifax, Canada (A.M.); School of Rehabilitation Science, McMaster University, Hamilton, Canada (P.S.); Selkirk College, Castlegar, Canada (S.M.); Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada (M.N.); Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada (M.N.); Unity Health Toronto, Toronto, Canada (B.B.); and Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania (G.S.L.).
A toolkit significantly increased the use of the 10-meter walk test (10mWT) and 6-minute walk test (6MWT) in stroke rehabilitation. This intervention improved documentation rates for these key physical therapy assessments.
Area of Science:
- Rehabilitation Medicine
- Clinical Assessment
- Physical Therapy Interventions
Background:
- The 10-meter walk test (10mWT) and 6-minute walk test (6MWT) are underutilized poststroke, despite being best practice for improving patient care.
- Effective implementation of these tests can enhance clinical decision-making and patient outcomes in stroke recovery.
Purpose of the Study:
- To evaluate the effectiveness of a toolkit designed to increase the adoption and utilization of the 10mWT and 6MWT by physical therapists (PTs) in stroke care.
- To assess the impact of a comprehensive toolkit, including educational materials and expert support, on the documentation rates of these functional mobility assessments.
Main Methods:
- A before-and-after study design was employed across 9 hospitals, involving 54 physical therapists and professional leaders.
- Participants received a toolkit (guide, app, video) and expert consultation over 5 months to facilitate test implementation.
- Health records of ambulatory patients were analyzed to compare the proportion of hospital visits with documented 10mWT/6MWT scores pre- and post-intervention.
Main Results:
- Post-intervention, the odds of implementing the 10mWT increased 12-fold (OR=12.4), and the 6MWT increased approximately 4-fold (OR=3.9).
- Documentation rates for the 10mWT/6MWT showed the most significant improvement in inpatient and outpatient rehabilitation settings.
- Adjustments were made for various clinical factors, including patient ambulation ability and presence of aphasia or cognitive impairment.
Conclusions:
- A comprehensive toolkit, supported by professional leaders, effectively enhanced the administration of the 10mWT and 6MWT in stroke rehabilitation settings.
- The findings suggest that targeted interventions can overcome barriers to best practice implementation for functional mobility assessments in poststroke care.
