title: Walking Training and Functioning Among Elderly Persons With Stroke: Results of a Prospective Cohort Study.
abstract: OBJECTIVE
  To determine if 65- to 85-year-old persons who had a stroke within the previous 3-36 months can improve functioning and quality of life during walking rehabilitation.
  
  
  METHODS
  Prospective cohort study with 6-month follow-up.
  
  
  METHODS
  Three inpatient rehabilitation centers and one outpatient rehabilitation center.
  
  
  METHODS
  A total of 147 persons who had sustained a stroke.
  
  
  METHODS
  The multidisciplinary rehabilitation intervention consisted of inpatient (20 days) or outpatient (18 days) rehabilitation with follow-up. Rehabilitation included walking exercises with and without body-weight support and conventional physiotherapy. After the rehabilitation period, participants received 10-15 individual physiotherapy sessions at outpatient clinics and guidance in home exercises.
  
  
  METHODS
  The 6-Minute Walking Test (6MWT), Berg Balance Scale (BBS), Assessment of Motor and Process Skills (AMPS), Functional Status Questionnaire (FSQ), Functional Independence Measure (FIM), WHO Quality of Life (WHOQOL-BREF), and Sense of Coherence (SOC-13) were administered at the beginning of rehabilitation and at 6-month follow-up.
  
  
  RESULTS
  Walking distance (6MWT) improved by 17 ± 51 meters (P < .001). The AMPS motor scale score improved by 0.15 ± 0.65 logits (P = .010), the process scale score improved by 0.10 ± 0.46 logits (P = .012), and the FSQ self-care score improved by 2.8 ± 15.8 points (P = .039). The changes in the total (4.2 ± 9.0), motor (3.7 ± 8.0), and cognitive (0.5 ± 2.0) scores of the FIM were statistically significant (P < .01). The BBS, WHOQOL-BREF, and SOC-13 remained unchanged.
  
  
  CONCLUSIONS
  Walking distance and both self-reported and measured functioning improved during walking rehabilitation among elderly persons who had a stroke. Maintaining or improving functioning through rehabilitation and self-administered exercises may be important in supporting mobility and independent living outside institutional care.
authors.affiliation: Department of Health Sciences, University of Jyväskylä, PO Box 35, Jyväskylä, FI-40014, Finland.|FCG Consulting Ltd, Helsinki, Finland.
authors.forename: Auli H
authors.initials: AH
authors.lastname: Karttunen
authors.affiliation: Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland.
authors.forename: Mauri
authors.initials: M
authors.lastname: Kallinen
authors.affiliation: Validia Rehabilitation, Lahti, Finland.
authors.forename: Sinikka H
authors.initials: SH
authors.lastname: Peurala
authors.affiliation: Department of Health Sciences and Department of Rehabilitation Medicine, University of Jyväskylä, Finland, and Central Hospital, Jyväskylä, Finland.
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking