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Predicting Discharge Walking Function With High-Intensity Stepping Training During Inpatient Rehabilitation in Nonambulatory Patients Poststroke
- Source :
- Archives of Physical Medicine and Rehabilitation. 103:S189-S196
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Objective This cohort investigation identified primary predictors of discharge walking function of nonambulatory individuals poststroke with high-intensity training (HIT) during inpatient rehabilitation. Design Observational cohort investigation. Setting Inpatient rehabilitation. Participants Data were collected from individuals (N=257) Intervention Clinical physical therapy interventions attempted to maximize stepping practice at higher intensities. Main Outcome Measures Primary outcomes included the discharge level of assistance required during walking (minimal or no assistance) and attainment of specific gait speed thresholds (0.4 and 0.8 m/s) during the 10-m walk test. Independent predictors were demographics, training interventions (including steps/day), baseline Berg Balance Scale (BBS), and paretic leg strength. Results Participants performed a median (interquartile range) of 1270 (533-2297) steps per day throughout inpatient rehabilitation, with significant differences between those who walked with versus without assistance at discharge. Logistic regressions indicate steps per day was a primary predictor of unassisted walking recovery; removal of steps per day resulted in primary predictors of baseline BBS and strength. Receiver operating characteristic (ROC) analyses indicate significant areas under the curve for BBS and relatively low cutoff scores of 5.5 points at admission to walk without assistance at any speed. ROC analyses performed using 1-week outcomes indicate BBS scores of 5-17 points were needed to achieve locomotor thresholds. Conclusion Stepping activity, BBS, and paretic leg strength were primary predictors of walking outcomes in patients performing HIT, and ROC analyses indicated recovery of independent walking could be achieved in low functioning patients early poststroke.
- Subjects :
- 030506 rehabilitation
medicine.medical_specialty
medicine.medical_treatment
Psychological intervention
Physical Therapy, Sports Therapy and Rehabilitation
Walking
Logistic regression
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Interquartile range
medicine
Humans
Inpatients
Rehabilitation
Receiver operating characteristic
business.industry
Stroke Rehabilitation
Patient Discharge
Exercise Therapy
Stroke
Berg Balance Scale
Cohort
Observational study
0305 other medical science
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 00039993
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- Archives of Physical Medicine and Rehabilitation
- Accession number :
- edsair.doi.dedup.....e78a7ecc55e925ebd79ff173a2617fd5