Walking velocity and modified rivermead mobility index as discriminatory measures for functional ambulation classification of chronic stroke patients

Abstract

Background:The cut-off values of walking velocity and classification of functional mobility both have a role in clinical settings for assessing the walking function of stroke patients and setting rehabilitation goals and treatment plans.Objective:The present study investigated whether the cut-off values of the modified Rivermead Mobility Index (mRMI) and walking velocity accurately differentiated the walking ability of stroke patients according to the modified Functional Ambulation Category (mFAC).Methods:Eighty two chronic stroke patients were included in the study. The comfortable/maximum walking velocities and mRMI were used to measure the mobility outcomes of these patients. To compare the walking velocities and mRMI scores for each mFAC point, one-way analysis of variance and the post-hoc test using Scheffe’s method were performed. The patients were categorized according to gait ability into either mFAC=VII or mFAC ≤ VI group. The cut-off values for mRMI and walking velocities were calculated using a receiver-operating characteristic curve. The odds ratios of logistic regression analysis (Wald Forward) were analyzed to examine whether the cut-off values of walking velocity and mRMI can be utilized to differentiate functional walking levels.Results:Except for mFACs III and IV, maximum walking velocity differed between mFAC IV and mFAC V (p<0.01), between mFAC V and mFAC VI (p<0.001), and between mFAC VI and mFAC VII (p<0.05). The cut-off value of mRMI is >26.5 and the area under the curve is 0.87, respectively; the cut-off value for comfortable walking velocity is >0.77 m/s and the area under the curve is 0.92, respectively; also, the cut-off value for maximum walking velocity is >0.92 m/s and the area under the curve is 0.97, respectively. In the logistic regression analysis, the maximum walking velocity (>0.92 m/s, OR=22.027) and mRMI (>26.5 scores, OR=10.283) are able to distinguish mFAC=VII from mFAC ≤ VI.Conclusion:The cut-off values of maximum walking velocity and mRMI are recommended as useful outcome measures for assessing ambulation levels in chronic stroke patients during rehabilitation.

Cutoff values of motor and cognitive measures for predicting and discriminating levels of activities of daily living after stroke: a scoping review

“…From the reference list of these 48 articles, potentially relevant references underwent primary and secondary screening, identifying 6 additional articles that met the eligibility criteria. In total, 54 articles [4,6,9–60] were selected for this scoping review (Fig. 1).…”

“…Lastly, discriminating between limited and unlimited community walkers (FAC = 5, mFAC = 7, comfortable walking speed >0.92 m/s [43], ≥7500 steps/day [62][63][64], Lord et al category [65]) was achieved with the following cutoffs for subacute cases: speed of 1.02 m/s in the 10-m walk test [38] and results of 75.0 and 73.9% for the 'Anticipatory Postural Adjustments' and 'Stability in Gait' scores of the BESTest, respectively [40]. Discriminating between the same parameters for chronic cases was achieved with the following cutoffs: distance of 288-367.5 m in the 6-min walk test [43,44,46,47], FMA-LL score of 25.5-27.6 [43,47], mRMI score of 26.5 [50], and BBS score of 46.5 [47]. While many studies utilized the 5-and 10-m walking tests to discriminate between limited and unlimited community walkers in patients with chronic stroke, significant variability was observed between studies, with comfortable speeds ranging from 0.47-0.93 m/s [4,43,45,46,50] and maximum speeds from 0.85-0.92 m/s [44,50].…”

Maze Control Training on Kinesthetic Awareness in Patients with Stroke: A Randomized Controlled Trial

“…The specific technique of PNF as an agonist to facilitate agonist (repeated contraction) was performed. Flexion-abduction-internal rotation and flexion-adduction-external rotation patterns were used for 10 minutes followed by a rest period for 3 minutes [ 22 ].…”

Intervention Effect of Rehabilitation Robotic Bed Under Machine Learning Combined With Intensive Motor Training on Stroke Patients With Hemiplegia

“…Fugl-Meyer Assessment Lower Extremity (FMA-LE) (Madhoun et al, 2020 ), Rivermead Mobility Index (RMI) (Lim et al, 2019 ), and Modified Barthel Index (MBI) (Taghizadeh et al, 2020 ) were adopted jointly to test and evaluate patients' motor function and mobility. The subjective state of the examination process and the environment had a certain impact, so it was necessary to be guided in accordance with the unified instructions.…”