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Walking Training and Functioning Among Elderly Persons With Stroke: Results of a Prospective Cohort Study
Author(s) -
Karttunen Auli H.,
Kallinen Mauri,
Peurala Sinikka H.,
Häkkinen Arja
Publication year - 2015
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2015.06.444
Subject(s) - rehabilitation , physical therapy , medicine , functional independence measure , berg balance scale , quality of life (healthcare) , prospective cohort study , stroke (engine) , cohort , physical medicine and rehabilitation , activities of daily living , mechanical engineering , nursing , engineering
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.