Walking recovery after an acute stroke: assessment with a new functional classification and the Barthel Index.
OBJECTIVE
To investigate walking recovery after an acute stroke by using both a new functional classification and the Barthel Index, and to identify factors associated with good recovery.


METHODS
A 1-year inception cohort study.


METHODS
In- and outpatient setting in a district hospital.


METHODS
Twenty-six patients with a prognosis of intermediate walking recovery.


METHODS
Conventional physical rehabilitation under professional supervision.


METHODS
Walking capacity was assessed with a new classification scale and the Barthel Index during 5 patient evolution stages (admission to the hospital, hospital and physiotherapy discharge, clinical review, end of study). We also assessed the severity of the paresis of the affected lower limb, the time lapse between the stroke until the recovery of the weight-bearing capacity of the affected leg, and finally the time until standing balance was regained.


RESULTS
We detected improvement in walking capacity throughout the follow-up process with our new classification scale, but not with the Barthel Index. Significant improvements were observed from the initial assessment, from 1 month onward, and from 3 to 12 months. The functional level of the final ambulation correlated negatively and significantly with the initial time to achieve weight-bearing capacity on the affected leg and also with the standing balance. There was also a significant correlation with the severity of lower-extremity paresis.


CONCLUSIONS
Patients experienced an improvement in walking recovery throughout the first year after their stroke. The early weight-bearing capacity of the affected leg and standing balance were associated with higher walking levels 1 year after the stroke.
Viosca
Enrique
E
Department of Physical Medicine and Rehabilitation, Hospital de Sagunt y C.E., Av. Ramón y Cajal s/n 46520, Puerto de Sagunto, Valencia, Spain. eviosca@ibv.upv.es
Lafuente
Rubén
R
Martínez
José L
JL
Almagro
Pedro L
PL
Gracia
Antonio
A
González
Carmen
C
D000368:Aged; D004185:Disability Evaluation; D005260:Female; D020233:Gait Disorders, Neurologic / Q000145:classification* / Q000503:physiopathology / Q000534:rehabilitation*; D006429:Hemiplegia / Q000503:physiopathology; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D017063:Outcome Assessment, Health Care; D010291:Paresis / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology