Recovery of walking ability in stroke patients through postacute care rehabilitation
Background: Walking entails orchestration of the sensory, motor, balance, and coordination systems, and walking disability is a critical concern after stroke. How and to what extent these systems influence walking disability after stroke and recovery have not been comprehensively studied. Methods: W...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Biomedical Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2319417022001044 |
| _version_ | 1827859981498580992 |
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| author | Chan-Lin Chu Tsong-Hai Lee Yueh-Peng Chen Long-Sun Ro Jung-Lung Hsu Yu-Cheng Chu Chih-Kuang Chen Yu-Cheng Pei |
| author_facet | Chan-Lin Chu Tsong-Hai Lee Yueh-Peng Chen Long-Sun Ro Jung-Lung Hsu Yu-Cheng Chu Chih-Kuang Chen Yu-Cheng Pei |
| author_sort | Chan-Lin Chu |
| collection | DOAJ |
| description | Background: Walking entails orchestration of the sensory, motor, balance, and coordination systems, and walking disability is a critical concern after stroke. How and to what extent these systems influence walking disability after stroke and recovery have not been comprehensively studied. Methods: We retrospectively analyzed patients with stroke in the Post-acute care-Cerebrovascular Diseases (PAC-CVD) program. We compared the characteristics of patient groups stratified by their ability to complete the 5-m walk test across various time points of rehabilitation. We then used stepwise linear regression to examine the degree to which each stroke characteristic and functional ability could predict patient gait performance. Results: Five hundred seventy-three patients were recruited, and their recovery of walking ability was defined by the timing of recovery in a 5-m walk test. The proportion of patients who could complete the 5-m walk test at admission, at 3 weeks of rehabilitation, at 6 weeks of rehabilitation, between 7 and 12 weeks of rehabilitation, and who could not complete the 5-m walk test after rehabilitation was 52.2%, 21.8%, 8.7%, 8.7%, and 8.6%, respectively. At postacute care discharge, patients who regained walking ability earlier had a higher chance of achieving higher levels of walking activity. Stepwise linear regression showed that Berg Balance Scale (BBS) (β: 0.011, p < .001), age (β: −0.005, p = .001), National Institutes of Health Stroke Scale (NIHSS) (6a + 6b; β: −0.042, p = .018), Mini-Nutritional assessment (MNA) (β: −0.007, p < .027), and Fugl–Meyer upper extremity assessment (FuglUE) (β: 0.002, p = .047) scores predicted patient's gait speed at discharge. Conclusion: Balance, age, leg strength, nutritional status, and upper limb function before postacute care rehabilitation are predictors of walking performance after stroke. |
| first_indexed | 2024-03-12T13:16:25Z |
| format | Article |
| id | doaj.art-539933a09cf94a9e873b1d9fe2cab28a |
| institution | Directory Open Access Journal |
| issn | 2319-4170 |
| language | English |
| last_indexed | 2024-03-12T13:16:25Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Biomedical Journal |
| spelling | doaj.art-539933a09cf94a9e873b1d9fe2cab28a2023-08-27T04:27:43ZengElsevierBiomedical Journal2319-41702023-08-01464100550Recovery of walking ability in stroke patients through postacute care rehabilitationChan-Lin Chu0Tsong-Hai Lee1Yueh-Peng Chen2Long-Sun Ro3Jung-Lung Hsu4Yu-Cheng Chu5Chih-Kuang Chen6Yu-Cheng Pei7Cheng Hsin General Hospital, Taipei, Taiwan; Master of Science Degree Program in Innovation for Smart Medicine, Chang Gung University, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanMaster of Science Degree Program in Innovation for Smart Medicine, Chang Gung University, Taoyuan, Taiwan; Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Neurology, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, New Taipei, TaiwanDepartment of Critical Care, Far-Eastern Hospital, Taipei, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan; Corresponding author. Chang Gung Memorial Hospital at Linkou, 5 Fuxing St., Gueishan, Taoyuan 333, Taiwan.Master of Science Degree Program in Innovation for Smart Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Corresponding author. Chang Gung Memorial Hospital at Linkou, 5 Fuxing St., Gueishan, Taoyuan 333, Taiwan.Background: Walking entails orchestration of the sensory, motor, balance, and coordination systems, and walking disability is a critical concern after stroke. How and to what extent these systems influence walking disability after stroke and recovery have not been comprehensively studied. Methods: We retrospectively analyzed patients with stroke in the Post-acute care-Cerebrovascular Diseases (PAC-CVD) program. We compared the characteristics of patient groups stratified by their ability to complete the 5-m walk test across various time points of rehabilitation. We then used stepwise linear regression to examine the degree to which each stroke characteristic and functional ability could predict patient gait performance. Results: Five hundred seventy-three patients were recruited, and their recovery of walking ability was defined by the timing of recovery in a 5-m walk test. The proportion of patients who could complete the 5-m walk test at admission, at 3 weeks of rehabilitation, at 6 weeks of rehabilitation, between 7 and 12 weeks of rehabilitation, and who could not complete the 5-m walk test after rehabilitation was 52.2%, 21.8%, 8.7%, 8.7%, and 8.6%, respectively. At postacute care discharge, patients who regained walking ability earlier had a higher chance of achieving higher levels of walking activity. Stepwise linear regression showed that Berg Balance Scale (BBS) (β: 0.011, p < .001), age (β: −0.005, p = .001), National Institutes of Health Stroke Scale (NIHSS) (6a + 6b; β: −0.042, p = .018), Mini-Nutritional assessment (MNA) (β: −0.007, p < .027), and Fugl–Meyer upper extremity assessment (FuglUE) (β: 0.002, p = .047) scores predicted patient's gait speed at discharge. Conclusion: Balance, age, leg strength, nutritional status, and upper limb function before postacute care rehabilitation are predictors of walking performance after stroke.http://www.sciencedirect.com/science/article/pii/S2319417022001044Postacute careStroke rehabilitationWalking abilityGait speedFunctional recovery |
| spellingShingle | Chan-Lin Chu Tsong-Hai Lee Yueh-Peng Chen Long-Sun Ro Jung-Lung Hsu Yu-Cheng Chu Chih-Kuang Chen Yu-Cheng Pei Recovery of walking ability in stroke patients through postacute care rehabilitation Biomedical Journal Postacute care Stroke rehabilitation Walking ability Gait speed Functional recovery |
| title | Recovery of walking ability in stroke patients through postacute care rehabilitation |
| title_full | Recovery of walking ability in stroke patients through postacute care rehabilitation |
| title_fullStr | Recovery of walking ability in stroke patients through postacute care rehabilitation |
| title_full_unstemmed | Recovery of walking ability in stroke patients through postacute care rehabilitation |
| title_short | Recovery of walking ability in stroke patients through postacute care rehabilitation |
| title_sort | recovery of walking ability in stroke patients through postacute care rehabilitation |
| topic | Postacute care Stroke rehabilitation Walking ability Gait speed Functional recovery |
| url | http://www.sciencedirect.com/science/article/pii/S2319417022001044 |
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