title: Factors related to community ambulation in patients with chronic stroke.
abstract: The focus of gait rehabilitation for walking in real-life settings should vary according to different aspects of gait performance. Investigation of factors related to impairments specific to community ambulation or activity participation may be helpful in determining and targeting appropriate treatment for gait rehabilitation. Objective To investigate the relationship between community ambulation and factors determining gait ability. Methods Forty-six outpatients with a previous stroke participated in a cross-sectional assessment. Community ambulation was assessed using a self-administered questionnaire. Outcome measures included impairments (strength, sensation, muscle tone, and balance) and ambulatory activity limitations (self-paced and maximum 10-m gait speed, 6-minute walking test, and concurrent manual/cognitive dual-task walking speed). Ability to increase speed and the dual-tasks cost were calculated. Multivariate analysis of variance and multiple regression analyses were used to determine differences in walking and identify important factors related to community ambulation. Results Pearson and Spearman analyses revealed that impairments (balance, r = .665; muscle strength, r = 0.653) and ambulatory activity limitation (gait speed, r = 0.684; walking distance, r = 0.654; ability to increase speed, r = 0.413) were significantly positively correlated with community ambulation level. Balance was an important factor in predicting increasing speed (P < 0.001). Muscle strength and tone were positive contributors to gait speed (P = 0.001 for both) and distance (P = 0.019 and P = 0.002, respectively). Cognitive and manual dual tasks showed no significant relationship to other variables. Stepwise multivariate regression analysis showed that important determinants of community ambulation level were strength (P < 0.001) and gait endurance (P = 0.001). Conclusions Muscle strength and walking distance are contributing factors in community ambulation for patients with chronic stroke.
authors.forename: Kyoung Bo
authors.initials: KB
authors.lastname: Lee
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Lim
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Ko
authors.forename: Yong Seong
authors.initials: YS
authors.lastname: Kim
authors.forename: Kang Sung
authors.initials: KS
authors.lastname: Lee
authors.forename: Byong Yong
authors.initials: BY
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D016138:Walking / Q000502:physiology*
keywords: chronic stroke,; community ambulation,; gait distance,; gait speed