Performance-based gait tests for acute stroke patients.

OBJECTIVE: Qualitative measures may not differentiate severity of deficits after an acute or subacute stroke. The aim of this study was to contrast the utility of performance-based gait tests with qualitative measures in a sample of acute stroke patients. DESIGN: Twenty acute stroke subjects had their performance-based gait measured by gait speed, walking distance, gait energy expenditure, and gait energy cost. They were also qualitatively evaluated for cognition, functional outcomes, motor impairment, and Functional Ambulation Category. RESULTS: Strong and significant correlations were observed among performance-based gait tests. Qualitative scales indicated moderate to minimal deficits in each domain evaluated, although they were not correlated among themselves, except for Functional Ambulation Category and FIM and FIM and Mini-Mental State Exam. Functional Ambulation Category correlated with performance-based gait tests. CONCLUSIONS: Performance-based gait tests are feasible to conduct during early recovery after a stroke and allow better discrimination among the patients than qualitative measures.

Gait outcomes after acute stroke rehabilitation with supported treadmill ambulation training: a randomized controlled pilot study.

OBJECTIVE: To investigate gait outcomes with supported treadmill ambulation training (STAT) associated with regular rehabilitation in acute stroke survivors. DESIGN: Randomized controlled trial, pilot study. SETTING: Rehabilitation medicine service at a Veterans Affairs medical center. PARTICIPANTS: Seven acute stroke survivors assigned to regular intervention group and 6 patients assigned to STAT intervention. INTERVENTIONS: Regular intervention consisted of 3 hours daily of physical therapy, kinesiotherapy, and occupational therapy. STAT group received regular rehabilitation with STAT substituted for usual gait training. Participants were tested at baseline, treated for an average of 3 weeks, and retested on discharge. The analysis of covariance procedure was used to test for differences between the 2 approaches. MAIN OUTCOME MEASURES: Functional Ambulation Category Scale, gait speed, walking distance, gait energy expenditure, and gait energy cost. RESULTS: The small sample size did not generate enough power to detect significant differences in any variable. However, medium to large effect sizes of 0.7 and 1.16 standard deviation units were observed for gait energy cost and walk distance, respectively. CONCLUSIONS: This pilot study indicated that STAT is a safe, feasible, and promising intervention for acute stroke survivors. A larger trial is warranted for statistical relevance.