Using Balance and Dual-Task Performance Evaluations to Determine a Stroke Patient's Functional Walking Ability

Abstract

[Purpose] We investigated which indices are effective for determining the functional walking ability of hemiplegic stroke patients.[Subjects] The subjects were 62 hemiplegic stroke patients (independent walking group, 34; unable to walk independently, 28) with more than a month since the onset of stroke. [Method] We evaluated the subjects with the 'Stops talking when walking' (SWWT) test, and four sub-items of the Functional Balance Scale (FBS: standing, transfers, forward reach, 360 turn) the cognitive and motor functions which are considered necessary at the time of walking. The FBS was evaluated as the number of items successfully achieved. For statistical analysis, the differences in the evaluated items between the two groups were examined. Those found to have significant differences were used as independent variables in logistic regression analysis with degree of functional walking as the dependent variable.[Results] We determined that independent walking was possible when: 1) FBS 4 items were achieved and walking continued in SWWT; 2) FBS 4 items were achieved and stopped walking in SWWT; and 3) FBS 3 items were achieved and walking continued in SWWT.[Conclusion] By adopting a novel index evaluating cognitive function during walking together with FBS from the novel perspective of numbers of items achieved, we consider that it is possible to arrive at a more practical evaluation of functional walking ability. We intend to actively pursue this line of research, to investigate the validity of our evaluation index. Key words: stroke patients, functional walking ability, evaluation

Usefulness of the Dual-Task Stepping Test to Determine the Independent Toileting Ability of Patients with Stroke Who Could Perform Stepping in a Seated Position

“…For subjects who did not take their food orally, the task was to list the types of medications they were currently taking. The usefulness and validity of these cognitive tasks have been confirmed in a previous study [23]. The subject's toileting ability assessment consists of dual-task: the motor task (stepping in place) and an cognitive task (to answer the lunch menu).…”

Development of an independent ambulation rating chart for post-stroke hemiplegic patients in the recovery stage: at what level is patients free to walk within rehabilitation ward

“…In stroke patients, various factors for falls have been reported, including the ability to perform activities of daily living, status of incontinence, balance ability, severity of motor palsy, status of unilateral spatial neglect, use of diuretics, and use of antidepressant or sedatives [1][2][3]. In addition, a large number of risk assessment tools for falls in post-stroke hemiplegic patients have been developed, such as 10-m walking time [4], lower limb muscle strength evaluation [5], one-leg stance time [5], Berg balance scale (BBS) [6][7][8][9], functional reach test (FR) [10], timed up and go test (TUG) [11], cognitive function evaluations such as dual-task [6,9,12], and higher order brain function evaluations [2,3,13]. In some tools such as the BBS, FR, TUG, and 10-m walking time, cutoff values for independent ambulation have been set.…”