Using balance and dual-task performance evaluations to determine a stroke patient's functional walking ability

Abstract

Purpose: We investigated which indices are effective for determining the functional walking ability of hemiplegic stroke patients. Subjects: The subjects were 62 hemiplegic stroke patients (independent walking group, 34; unable to walk independently, 28) with more than a month since the onset of stroke. Methods: We evaluated the subjects with the 'Stops talking when walking' (SWWT) test, and four sub-items of the Functional Balance Scale (FBS: standing, transfers, forward reach, 360° turn) the cognitive and motor functions which are considered necessary at the time of walking. The FBS was evaluated as the number of items successfully achieved. For statistical analysis, the differences in the evaluated items between the two groups were examined. Those found to have significant differences were used as independent variables in logistic regression analysis with degree of functional walking as the dependent variable. Results: We determined that independent walking was possible when: 1) FBS 4 items were achieved and walking continued in SWWT; 2) FBS 4 items were achieved and stopped walking in SWWT; and 3) FBS 3 items were achieved and walking continued in SWWT. Conclusion: By adopting a novel index evaluating cognitive function during walking together with FBS from the novel perspective of numbers of items achieved, we consider that it is possible to arrive at a more practical evaluation of functional walking ability. We intend to actively pursue this line of research, to investigate the validity of our evaluation index.