title: Predictors of gait velocity among community-dwelling stroke survivors.
abstract: BACKGROUND
  Gait velocity is an objective, fundamental indicator of post-stroke walking ability. Most stroke survivors have diminished aerobic endurance or paretic leg strength affecting their walking ability. Other reported underlying factors affecting gait velocity include functional disability, balance, cognitive impairment, or the distance they are required to walk.
  
  
  OBJECTIVE
  To examine the relationship between gait velocity and measures of physical and cognitive functioning in chronic stroke.
  
  
  METHODS
  Cross-sectional design using baseline data from community-dwelling stroke survivors enrolled in an exercise intervention study. Functional disability (modified Rankin Scale), aerobic endurance (2-min step-test), leg strength (timed 5-chair stand test), balance (single-leg stance) and cognitive impairment (Mini-Mental Status Exam) were assessed. Gait velocity was assessed using a timed 4-m walk test. Multiple linear regression was used to explore potential independent predictors of gait velocity.
  
  
  RESULTS
  Subjects had an average gait velocity of 0.75±0.23m/s, categorized as limited community walkers. Approximately 37% of the variance in gait velocity, could be explained by the 5 independent variables, functional disability, aerobic endurance, leg strength, balance, and cognitive impairment (R(2)=0.37, F(5,74)=8.64, p<0.01). Aerobic endurance (t(1,74)=3.41, p<0.01) and leg strength (t(1,74)=-2.23, p=0.03) contributed significantly to gait velocity.
  
  
  CONCLUSIONS
  Diminished aerobic endurance and leg strength are major contributors to slow gait velocity in chronic stroke. Long term rehabilitation efforts are needed to improve gait velocity in chronic stroke, and may need to incorporate multifaceted strategies concurrently, focusing on aerobic endurance and leg strength, to maximize community ambulation and reintegration.
authors: College of Nursing, University of Arizona, Tucson, AZ, USA. rtaylor@nursing.arizona.edu
authors: Ruth E
authors: RE
authors: Taylor-Piliae
authors: L Daniel
authors: LD
authors: Latt
authors: Joseph T
authors: JT
authors: Hepworth
authors: Bruce M
authors: BM
authors: Coull
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D057187:Independent Living; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D004856:Postural Balance / Q000502:physiology*; D011237:Predictive Value of Tests; D011788:Quality of Life; D020127:Recovery of Function; D012111:Residence Characteristics; D018570:Risk Assessment; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D000071939:Stroke Rehabilitation; D017741:Survivors; D016896:Treatment Outcome