Enhanced life-role participation in response to comprehensive gait training in chronic-stroke survivors.
OBJECTIVE
Intensive gait training can produce improvements in gait and function (> 6 months after stroke); however, findings are mixed for enhanced life-role participation. Therefore, it is unclear if improved gait and function translate into life-role participation gain. Our objective was to evaluate whether intensive gait therapy can produce improvements in life-role participation for chronic-stroke survivors, according to a comprehensive measure dedicated to life-role participation.


METHODS
In conjunction with a clinical gait-training trial, we conducted a secondary analysis for a 44-member cohort with stroke (> 6 months). Gait-training interventions included functional neuromuscular stimulation, body-weight supported treadmill training, over-ground gait training and exercise for 1.5 hours/day, 4 days/week for 12 weeks. Study measures included Tinetti Gait (gait impairment), Functional Independence Measure (FIM, function), Stroke Impact Scale subscale of life-role participation (SIS part) and Craig Handicap Assessment and Reporting Technique (CHART, life-role participation). Analysis included Wilcoxon signed rank test and polytomous universal regression model.


RESULTS
Gait interventions produced significant improvement in CHART (p = 0.020), SIS part (p = 0.011), FIM (p < 0.0001), and Tinetti Gait (p < 0.0001). Age, gender and time since stroke did not predict response to treatment.


CONCLUSIONS
Intensive gait therapy resulted in significant gain in life-role participation, according to a comprehensive measure, so dedicated.
Neurology and Research, Cleveland VA Medical Center, Cleveland, OH 44106, USA. svetlana.pundik@case.edu
Svetlana
S
Pundik
John
J
Holcomb
Jessica
J
McCabe
Janis J
JJ
Daly
D000328:Adult; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000379:methods*; D015444:Exercise; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011788:Quality of Life; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D000071939:Stroke Rehabilitation; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking; D016474:Weight-Bearing