Article

Gait velocity is an objective, fundamental indicator of post-stroke
walking ability. Most stroke survivors have diminished aerobic endurance or
paretic leg strength affecting their walking ability. Other reported underlying
factors affecting gait velocity include functional disability, balance, cognitive
impairment, or the distance they are required to walk. OBJECTIVE: To examine the
relationship between gait velocity and measures of physical and cognitive
functioning in chronic stroke. METHODS: Cross-sectional design using baseline
data from community-dwelling stroke survivors enrolled in an exercise
intervention study. Functional disability (modified Rankin Scale), aerobic
endurance (2-min step-test), leg strength (timed 5-chair stand test), balance
(single-leg stance) and cognitive impairment (Mini-Mental Status Exam) were
assessed. Gait velocity was assessed using a timed 4-m walk test. Multiple linear
regression was used to explore potential independent predictors of gait velocity.
RESULTS: Subjects had an average gait velocity of 0.75+/-0.23m/s, categorized as
limited community walkers. Approximately 37% of the variance in gait velocity,
could be explained by the 5 independent variables, functional disability, aerobic
endurance, leg strength, balance, and cognitive impairment (R(2)=0.37,
F(5,74)=8.64, p<0.01). Aerobic endurance (t(1,74)=3.41, p<0.01) and leg strength
(t(1,74)=-2.23, p=0.03) contributed significantly to gait velocity. CONCLUSION:
Diminished aerobic endurance and leg strength are major contributors to slow gait
velocity in chronic stroke. Long term rehabilitation efforts are needed to
improve gait velocity in chronic stroke, and may need to incorporate multifaceted
strategies concurrently, focusing on aerobic endurance and leg strength, to
maximize community ambulation and reintegration.
CI - Copyright A(c) 2011 Elsevier B.V. All rights reserved.

Langue : ANGLAIS