Recovery of Paretic Lower Extremity Loading Ability and Physical Function in the First Six Months After Stroke

To evaluate post-stroke recovery of paretic lower extremity loading, walking ability, and self-reported physical function, and to identify subject characteristics associated with recovery

Recovery of Paretic Lower Extremity Loading Ability and Physical Function in the First Six Months After Stroke

OBJECTIVE: To evaluate post-stroke recovery of paretic lower extremity loading, walking ability, and self-reported physical function, and to identify subject characteristics associated with recovery. DESIGN: Inception cohort study, with testing at monthly intervals from one to six months post stroke. SETTING: University medical center and research laboratory. PARTICIPANTS: Volunteer sample of individuals with first-ever, unilateral, non-cerebellar stroke. A total of 78 individuals underwent screening, and 45 were found to be eligible. Of these, 8 declined participation, 2 were excluded because of deteriorating cognitive status, and 2 were lost to follow-up. The remaining 33 individuals enrolled in the study, and 30 (91%) completed the study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Outcomes were loading of the paretic lower extremity when standing up from a chair (PLEL), self-selected gait speed (GS), and Physical Functioning Index (PFI). RESULTS: Data analyses using linear mixed models indicated that subjects improved over time for all outcomes. Baseline Fugl-Meyer lower extremity motor scale score was a predictor of immediate post-stroke performance for PLEL and GS, and of recovery rate for PLEL. Factors identified as having significant effects on performance at 6 months post stroke were baseline Fugl-Meyer lower extremity motor scale score for PLEL and GS, and baseline star cancellation score (from the Behavioral Inattention Test) for PLEL. CONCLUSION: Individuals with better baseline paretic lower extremity motor function have better ability to load that extremity during functional activities and faster walking speeds, and these advantages are still present at 6 months post stroke. Individuals with severe visuospatial neglect demonstrate less ability to load the paretic leg during functional activities at 6 months post stroke

Step Test Scores Are Related to Measures of Activity and Participation in the First 6 Months After Stroke

Background: The Step Test (ST) is a measure of dynamic standing balance and paretic–lower-extremity motor control in patients with stroke. Little is known about the extent to which impairments assessed by the ST relate to activity and participation during stroke recovery