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); 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 significant improvements in life role participation for chronic stroke survivors.


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 exercise, body weight supported treadmill training (BWSTT), over-ground gait training, and functional electrical stimulation (FES) for 1.5 h/day, 4 days/wk for 12 weeks. Study measures included Tinetti Gait (TG) (gait impairment), Functional Independence Measure (FIM, function), Stroke Impact Scale Subscale of Life Role Participation (SISpart), and Craig Handicap Assessment & Reporting Technique (CHART, life-role participation). Analyses included Wilcoxon Signed Rank Test and PLUM Regression Model.


RESULTS
Gait interventions produced significant improvement in CHART (p = 0.020), SISpart (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, multi-modal, long-duration gait therapy resulted in significant gain in life-role participation, according to a relatively comprehensive, homogeneous measure.
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*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018709:Statistics, Nonparametric; D020521:Stroke / Q000503:physiopathology / Q000628:therapy; D000071939:Stroke Rehabilitation; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking; D016474:Weight-Bearing