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Walking Training and Functioning Among Elderly Persons With Stroke: Results of a Prospective Cohort Study.

PM & R : the journal of injury, function, and rehabilitation
December 1, 2015
Auli H Karttunen et al. (4 authors)
Journal ArticleMulticenter StudyRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

To determine if walking rehabilitation improves functioning and quality of life in 65- to 85-year-old persons who had a stroke within the previous 3-36 months.

Results Summary

Walking distance and both self-reported and measured functioning improved significantly during rehabilitation, though quality of life and balance measures remained unchanged. The intervention showed statistically significant improvements in motor skills, self-care, and functional independence.

Population

65- to 85-year-old persons who had a stroke within the previous 3-36 months.

Effective Dosage

Inpatient (20 days) or outpatient (18 days) rehabilitation, followed by 10-15 individual physiotherapy sessions and home exercises.

Duration

6 months (including follow-up).

Interactions

None mentioned.

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
increase
Walking distance (6-Minute Walking Test)
65- to 85-year-old persons who had a stroke within the previous 3-36 months
17 ± 51 meters
improved
#1
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
increase
AMPS motor scale score
65- to 85-year-old persons who had a stroke within the previous 3-36 months
0.15 ± 0.65 logits
improved
#2
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
increase
AMPS process scale score
65- to 85-year-old persons who had a stroke within the previous 3-36 months
0.10 ± 0.46 logits
improved
#3
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
increase
FSQ self-care score
65- to 85-year-old persons who had a stroke within the previous 3-36 months
2.8 ± 15.8 points
improved
#4
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
increase
total score of the FIM
65- to 85-year-old persons who had a stroke within the previous 3-36 months
4.2 ± 9.0
statistically significant changes
#5
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
increase
motor score of the FIM
65- to 85-year-old persons who had a stroke within the previous 3-36 months
3.7 ± 8.0
statistically significant changes
#6
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
increase
cognitive score of the FIM
65- to 85-year-old persons who had a stroke within the previous 3-36 months
0.5 ± 2.0
statistically significant changes
#7
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
no change
Berg Balance Scale (BBS)
65- to 85-year-old persons who had a stroke within the previous 3-36 months
-
remained unchanged
#8
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
no change
WHO Quality of Life (WHOQOL-BREF)
65- to 85-year-old persons who had a stroke within the previous 3-36 months
-
remained unchanged
#9
multidisciplinary rehabilitation intervention consisting of inpatient or outpatient rehabilitation with follow-up, including walking exercises with and without body-weight support, conventional physiotherapy, and subsequent individual physiotherapy sessions with guidance in home exercises
no change
Sense of Coherence (SOC-13)
65- to 85-year-old persons who had a stroke within the previous 3-36 months
-
remained unchanged
#10
Abstract

OBJECTIVE: To determine if 65- to 85-year-old persons who had a stroke within the previous 3-36 months can improve functioning and quality of life during walking rehabilitation. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: Three inpatient rehabilitation centers and one outpatient rehabilitation center. PARTICIPANTS: A total of 147 persons who had sustained a stroke. INTERVENTION: The multidisciplinary rehabilitation intervention consisted of inpatient (20 days) or outpatient (18 days) rehabilitation with follow-up. Rehabilitation included walking exercises with and without body-weight support and conventional physiotherapy. After the rehabilitation period, participants received 10-15 individual physiotherapy sessions at outpatient clinics and guidance in home exercises. MEASUREMENTS: The 6-Minute Walking Test (6MWT), Berg Balance Scale (BBS), Assessment of Motor and Process Skills (AMPS), Functional Status Questionnaire (FSQ), Functional Independence Measure (FIM), WHO Quality of Life (WHOQOL-BREF), and Sense of Coherence (SOC-13) were administered at the beginning of rehabilitation and at 6-month follow-up. RESULTS: Walking distance (6MWT) improved by 17 ± 51 meters (P < .001). The AMPS motor scale score improved by 0.15 ± 0.65 logits (P = .010), the process scale score improved by 0.10 ± 0.46 logits (P = .012), and the FSQ self-care score improved by 2.8 ± 15.8 points (P = .039). The changes in the total (4.2 ± 9.0), motor (3.7 ± 8.0), and cognitive (0.5 ± 2.0) scores of the FIM were statistically significant (P < .01). The BBS, WHOQOL-BREF, and SOC-13 remained unchanged. CONCLUSIONS: Walking distance and both self-reported and measured functioning improved during walking rehabilitation among elderly persons who had a stroke. Maintaining or improving functioning through rehabilitation and self-administered exercises may be important in supporting mobility and independent living outside institutional care.

Medical Subject Headings (MeSH)
Activities of Daily LivingAgedAged, 80 and overCognitive Behavioral TherapyExercise TherapyFemaleFollow-Up StudiesHumansMaleProspective StudiesStrokeStroke RehabilitationTime FactorsTreatment OutcomeWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations5
Citations/Year0.5
Relative Citation Ratio0.28
NIH Percentile14.4%
Research Impact Scores
APT Score0.25
Weight Score1.57
Normalized Score0.70
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