Key Facts
- Two thirds of the patients are unable to walk without assistance in the first week after stroke. Jorgensen HS et al. Arch Phys Med Rehabil, 1995.
- Approximately 35% of survivors with initial paralysis of the leg do not regain useful walking function. Hendricks HT et al. Arch Phys Med Rehabil, 2002.
- Although 65% to 85% of stroke survivors learn to walk independently by 6 months post stroke, gait abnormalities and poor endurance persists through the chronic stages of the condition. Wade DT et al. Scand J Rehabil Med, 1987.
Research Findings
- Exercise and cardiovascular training using equipment like an Exercise Aid or Leg Bike are beneficial for stroke patients.
- Electrical Stimulation and EMG-Triggered Stimulation can improve walking ability.
- Electrical Stimulation can reduce spasticity.
- Lower Limb Robot-Assisted Therapy Device can improve functional walking performance.
- A Foot Drop Brace can improve ambulation.
- A Lower Limb Contracture Splint can prevent ankle contracture.
- Virtual Reality/Exercise Games and Biofeedback may enhance gait performance.
- Balance training may be beneficial to stroke patients.
- Gait training (i.e., treadmill training) with Body Weight Support can be beneficial.
- Mental practice (rehearsing tasks mentally) can be beneficial for transfers and mobility.
- Botulinum Toxin (Botox) decreases spasticity and increases range of motion.
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Mobility and Leg Outcome Measures
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- Berg Balance Scale – The BBS quantitatively assesses balance in older adults.
- Fugl-Meyer Assessment – The Fugl-Meyer Assessment (FMA) is a stroke-specific, performance-based impairment index. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post-stroke hemiplegia. It is applied clinically and in research to determine disease severity, describe motor recovery, and to plan and assess treatment.
- Functional Ambulation Categories – The Functional Ambulation Categories (FAC) is a functional walking test that evaluates ambulation ability. This 6-point scale assesses ambulation status by determining how much human support the patient requires when walking, regardless of whether or not they use a personal assistive device. The FAC can be used with, but is not limited to, patients with stroke.
- GaitRITE – The GaitRITE system was developed in response to the need for an objective way to quantify gait and ambulatory status. The GAITRite System measures spatio-temporal parameters of gait such as cadence, step length and velocity, providing clinically relevant information that is useful in devising treatment plans and evaluating treatment outcomes. The system tracks parameters over time and can be used to generate progress and status reports.
- Postural Assessment Scale for Stroke Patients – The PASS assesses balance in lying, sitting and standing positions. It was designed specifically for patients with stroke and is suitable for all individuals regardless of postural performance.
- Rivermead Mobility Index – The Rivermead Mobility Index (RMI) was developed from the Rivermead Motor Assessment Gross Function subscale as a means to quantify mobility disability in clients with stroke. The RMI is clinically relevant in testing functional abilities such as gait, balance, and transfers.
- Six-Minute Walk Test – The Six-Minute Walk Test (6MWT) is a functional walking test in which the distance that a client can walk within six minutes is evaluated. This test has been used to assess individuals with stroke, head injury, and Parkinson’s disease, as well as pulmonary and cardiac diseases.
- Timed Up and Go – The Timed Up and Go (TUG) is a screening tool used to test basic mobility skills of frail elderly patients (60-90 years old). The TUG can be used with, but is not limited to, persons with stroke.
References