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Utility of Community-Based Gait Speed Outcome Measures and Cut-Offs for Stroke
Suzanne R O'Brien1, Michelle Denninger, Tara Moore
1Decker College of Nursing and Health Sciences, Division of Physical Therapy, Binghamton University, 48 Corliss Avenue, Johnson City, NY 13790, USA. Tel 607-777-4697. sobrien@binghamton.edu.
Journal of Allied Health
|March 5, 2025
Summary
Physical therapy improved gait speed (GS) in chronic stroke survivors, particularly measured by the 6-minute walk test. The Fulk categories offer better utility for community-dwelling stroke patients to prevent functional declines.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Physical Therapy
Background:
- Chronic stroke often leads to decreased gait speed (GS), impacting participation, endurance, and increasing institutionalization risk.
- Gait speed categories by Perry and Fulk aid in defining gait function and setting rehabilitation goals.
- The optimal GS tests and categories for goal-setting in community-dwelling chronic stroke patients remain unclear.
Purpose of the Study:
- To evaluate the utility of different gait speed (GS) tests and functional categories for goal setting in community-dwelling patients with chronic stroke.
- To determine which GS measurement tools (10-meter walk test and 6-minute walk test) and classification systems (Perry and Fulk) are most effective for rehabilitation planning.
Main Methods:
- Observational cohort study involving 21 community-dwelling patients with severe chronic stroke.
- Intervention consisted of 10 weekly 1-hour pro-bono physical therapy sessions.
- Gait speed was assessed using the 10-meter walk test (10MWT) and 6-minute walk test (6MWT).
Main Results:
- Improvements were observed in the 6-minute walk test (6MWT) (p=0.023), but not the 10-meter walk test (10MWT) (p=0.569).
- Neither test reached the minimum clinically important difference.
- Fewer participants achieved the higher Fulk gait speed categories compared to the Perry categories at discharge.
Conclusions:
- Physical therapy intervention showed a positive association with improved gait speed (GS) as measured by the 6MWT, though not the 10MWT.
- The limited intervention dose may have attenuated treatment effects.
- The Fulk functional gait speed categories demonstrated greater utility for program planning in community-dwelling severe stroke survivors, potentially preventing further functional decline.
