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Cited by 269Stroke Rehabilitation and RecoveryBalance, Gait, and Falls PreventionAcute Ischemic Stroke Management

Predicting Improvement in Gait After Stroke: A Longitudinal Prospective Study

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Kollen, Boudewijn, van de Port, Ingrid, Lindeman, Eline, Twisk, Jos, Kwakkel, Gert·2005·Stroke
DOI 10.1161/01.str.0000190839.29234.50
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Abstract

Background and Purpose— To study the longitudinal relationship of functional change in walking ability and change in time-dependent covariates and to develop a multivariate regression model to predict longitudinal change of walking ability. Methods— A total of 101 acute stroke patients with first-ever ischemic middle cerebral artery strokes was used as the population. Prospective cohort study based on 18 repeated measurements over time during the first poststroke year. Baseline characteristics as well as longitudinal information from functional ambulation categories (FAC), Fugl–Meyer leg score (FM-leg), Motricity index leg score (MI-leg), letter cancellation task (LCT), Fugl-Meyer balance (FM-balance), and timed balance test (TBT) were obtained. Intervention consisted of a basic rehabilitation program with additional arm, leg, or air splint therapy. Main outcome measure constituted change scores on FAC over time. Results— In total, 1532 of the 1717 change scores were available for regression analysis. The regression model showed that TBT change scores were the most important factor in predicting improvement on FAC (β=0.094; P <0.001) followed by changes scores on FM-leg (β=0.014; P <0.001) and reduction in LCT omissions (β=−0.010; P <0.001) and MI leg test (β=0.001; P <0.001). In addition, time itself was significantly negatively associated with improvement (β=−0.002; P <0.001). Conclusion— Improvement in standing balance control is more important than improvement in leg strength or synergism to achieve improvement in walking ability, whereas reduction in visuospatial inattention is independently related to improvement of gait. Finally, time itself is an independent covariate that is negatively associated with change on FAC, suggesting that most pronounced improvements occur earlier after stroke.

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Authors
Kollen, B., van de Port, I., Lindeman, E., Twisk, J., & Kwakkel, G.
Affiliations
  • University Medical Center Utrecht (NL)
  • From the Research Bureau (B.K.), Isala klinieken, Zwolle, The Netherlands; Rehabilitation Centre “De Hoogstraat”, Rudolf Magnus Institute of Neuroscience, UMC Utrecht (I.v.d.P., E.L., G.K.), The Netherlands; and EMGO Institute/Department of KEB (J.T.), VU Medical Centre, Amsterdam, The Netherlands.
ORCID
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-12
Volume
36
Issue
12
Pages
2676-2680
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/01.str.0000190839.29234.50
OpenAlex
W2141036954
Cited by
269
References
24
Citations by year
2026: 8 · 2025: 12 · 2024: 12 · 2023: 10 · 2022: 14 · 2021: 17 · 2020: 24 · 2019: 5 · 2018: 16 · 2017: 9 · 2016: 16 · 2015: 12 · 2014: 27 · 2013: 13 · 2012: 12
FWCI
8.50
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Stroke (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
ZonMw
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
Keywords
gait recovery, walking ability, Functional Ambulation Category, standing balance, Fugl-Meyer Assessment, leg strength, splint therapy, rehabilitation, ischemic stroke, middle cerebral artery stroke
MeSH terms
Adult, Female, Gait, Humans, Longitudinal Studies, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Multivariate Analysis, Logistic Models, Recovery of Function, Infarction, Middle Cerebral Artery

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