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Background. The Step Test (ST) is a measure of dynamic standing balance and paretic-lower-extremity motor control in patients with stroke. Little is known about the extent to which impairments assessed by the ST relate to activity and participation during stroke recovery. Objective. The purpose of this study was to determine relationships between ST scores and measures of activity and participation during the first 6 months after stroke. Design. This was a prospective cohort study. Methods. Thirty-three individuals (18 men, 15 women) with a diagnosis of a single, unilateral stroke participated in the study. Participants were tested one time per month from 1 to 6 months poststroke. The ST was considered an impairment-level measure. Self-selected gait speed and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) Physical Function Index (PFI) were used to assess physical function. Three domains (mobility, basic and instrumental activities of daily living, participation) of the Stroke Impact Scale were used to assess sell-reported disability. Regression analyses were conducted to examine the bivariate associations between ST scores and each physical function and disability measure at each time point (1-6 months). Results. The ST scores were positively associated with both physical function measures. The associations were stronger for self-selected gait speeds ([R.sup.2] = .60-.79) than for the PFI scores ([R.sup.2] =.32-.60). During the first 6 months after stroke, each additional step with the paretic lower extremity on the ST corresponded to a 0.07-m/s to 0.09-m/s increase in gait speed, and each additional step with the nonparetic lower extremity was associated with a 0.07-m/s to 0.08-m/s gait speed increase. The impairment-disability associations were weaker than the impairment-physical function associations. Limitations. Limitations of the study include a relatively small sample size and lack of examiner blinding with regard to participant characteristics. Conclusions. Impairments in balance and paretic-lower-extremity motor control, as measured by the ST, relate to physical function and disability during the first 6 months following stroke., About 780,000 people in the United States experience a stroke each year. (1) Although some survivors of a stroke achieve a full recovery in physical function, approximately one haft have [...]

Background. Weight bearing through, or 'loading' of, the paretic lower extremity and transfer of weight from one lower extremity to the other are important impairment-level goals of stroke rehabilitation. Improvements in these limb-loading and weight-transfer abilities have been shown to relate to improved performance of many functional activities. Unfortunately, valid and practical clinical measures of paretic-lower-extremity loading and weight transfer have not been identified. Objective. The purpose of this study was to assess convergent validity of the Step Test (ST) and the knee extension component of the Upright Motor Control Test (UMCe) as measures of paretic-limb loading and of the Repetitive Reach Test (RR) as a measure of weight transfer in the first 6 months after stroke. Design. This was a prospective cohort study of 33 adults with lower-extremity motor impairment following unilateral, noncerebellar stroke. Participants were tested one time per month from 1 to 6 months poststroke. Results. Scores on the ST (performed with the nonparctic leg as the stepping leg) and UMCc were positively correlated with peak vertical ground reaction forces (GRFs) beneath the paretic limb during functional tasks ([R.sup.2] =.35-.76 for the ST, pseudo [R.sup.2]=.21-.34 for the UMCe). Scores on the RR were positively correlated with change in vertical GRF beneath the paretic limb during the diagonal reach task ([R.sup.2]=.45) and with weight-transfer time during stepping with the nonparetic limb ([R.sup.2] =. 15). Conclusions. The ST, performed with the nonparetic leg as the stepping leg, is a valid measure of paretic-limb loading during stroke recovery. Of the clinical measures tested, the ST correlated most strongly with the force platform measures., Stroke is a leading cause of long-term disability in the United States. The estimated number of people who have survived a stroke stands at 5,500,000 (1) and is expected to [...]