Gait and Balance Outcome Measures Are Responsive in Severely Impaired Individuals Undergoing Inpatient Stroke Rehabilitation

Christopher Henderson*, Roberta Virva, Lauren Lenca, John F. Butzer, Linda Lovell, Elliot Roth, T. George Hornby, Jennifer L. Moore

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To investigate whether gait and balance outcome measures in patients with severe gait and balance impairments at admission to inpatient rehabilitation provided additional and meaningful information beyond customary measures. Specifically, this study investigated whether individuals who obtained low scores at admission exhibited improvements that exceeded the established minimal detectable change during inpatient rehabilitation. We also investigated whether gait outcomes would capture changes in function not identified by customary measures. Design: Secondary analysis of a knowledge translation project aimed at increasing the systematic collection of these outcome measures in a poststroke cohort. Setting: Subacute inpatient rehabilitation facility. Participants: Individuals<2 months poststroke (N=157) with 34-43 with severe deficits including Berg Balance Scale≤5, 10-meter walk test=0 m/s, or 6-minute walk test=0 m. Intervention: Not applicable. Main outcome measures: Berg Balance Scale, 10-meter walk test, 6-minute walk test. Results: After 1 week of rehabilitation, 41%-53% of severely impaired individuals had changes above minimal detectable changes in gait and balance outcomes, which increased to 68%-84% at discharge. Across the entire cohort, FIM locomotion scores failed to identify changes in gait function for 35% of participants after 1 week of rehabilitation. Conclusions: Routine assessment of gait and balance outcome measures in patients with severe deficits early poststroke may be beneficial. These measures were responsive after 1 week of rehabilitation and detected changes not captured by customary measures. Routine use of a standardized gait and balance assessments may provide clinicians with important information to guide clinical decision making.

Original languageEnglish (US)
Pages (from-to)1210-1212.e1
JournalArchives of physical medicine and rehabilitation
Volume103
Issue number6
DOIs
StatePublished - Jun 2022

Keywords

  • Gait
  • Health care
  • Implementation science
  • Neurologic
  • Neurological Rehabilitation
  • Outcome assessment, Physical and rehabilitation medicine
  • Rehabilitation
  • Translational medical research
  • Walking speed

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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