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

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.