The development of Ambulation Independence Measure: A new measurement tool to assess gait ability in acute stroke patients

Abstract

BACKGROUND: The assessment of gait function is important for stroke rehabilitation. Gait function of patients with stroke often depends on the type of orthosis. There are however few gait assessments that assess the type of orthosis. OBJECTIVE: The purpose of this study was to investigate the reliability and validity of our newly developed Ambulation Independence Measure (AIM), which assesses the gait function, type of orthoses and physical assistance, for acute stroke patients. METHODS: A total of 73 acute stroke patients participated in this prospective study. The AIM discriminates 7 levels of gait ability on the basis of the amount of physical assistance required and orthoses that are used during walking. Interrater reliability, concurrent validity with the Functional Ambulation Category (FAC) and predictive validity were examined. RESULTS: The weighted kappas of AIM at the start of gait training (baseline) and discharge were 0.990 and 0.978, respectively. The AIM scores were significantly correlated with the FAC scores at both baseline (r = 0.808) and discharge (r = 0.934). Multiple regression analyses showed that the AIM at baseline was a stronger predictor of the FAC at discharge (R2 = 0.80). CONCLUSIONS: The AIM has excellent reliability, concurrent validity, predictive validity, and good responsiveness in acute stroke patients.

Quadriceps muscle activity during walking with a knee ankle foot orthosis is associated with improved gait ability in acute hemiplegic stroke patients with severe gait disturbance

“…The diagnosis of stroke was based on each patient’s clinical history, neurological examination, and head computed tomography or magnetic resonance imaging. The inclusion criteria were as follows: (1) first unilateral hemispheric stroke; and (2) severe gait disturbance (AIM score 1 or 2) ( 11 ).…”

“…To prove this hypothesis, it is necessary to examine the association between muscle activities during walking with a KAFO and the gait ability with an AFO. The Ambulation Independence Measure (AIM), a gait assessment tool we developed, is useful for assessing the gait ability with an AFO in stroke patients ( 11 ). The AIM is a measurement tool that assesses gait ability, type of orthoses, and physical assistance of stroke patients ( 11 ).…”

“…The Ambulation Independence Measure (AIM), a gait assessment tool we developed, is useful for assessing the gait ability with an AFO in stroke patients ( 11 ). The AIM is a measurement tool that assesses gait ability, type of orthoses, and physical assistance of stroke patients ( 11 ). A key feature of the AIM is that it limits the type of orthoses during the scoring walking test ( 11 ).…”

“…The AIM is a measurement tool that assesses gait ability, type of orthoses, and physical assistance of stroke patients ( 11 ). A key feature of the AIM is that it limits the type of orthoses during the scoring walking test ( 11 ). Specifically, an AFO is permitted, but a KAFO or other orthoses are not allowed.…”

“…Specifically, an AFO is permitted, but a KAFO or other orthoses are not allowed. An AIM score of 3 or more indicates that a KAFO is clinically unnecessary for the patient, and the patient is clinically able to convert from a KAFO to an AFO ( 11 ). In this study, this hypothesis will be examined in acute stroke patients with severe gait disturbances.…”