title: Hemiparetic Knee Extensor Strength and Balance Function Are Predictors of Ambulatory Function in Subacute Stroke Patients.
abstract: OBJECTIVE
  To identify the potential predictors of ambulatory function in subacute stroke patients, and to determine the contributing factors according to gait severity.
  
  
  METHODS
  Fifty-three subacute stroke patents were enrolled. Ambulatory function was assessed by gait speed and endurance. Balance function was evaluated by the Berg Balance Scale score (BBS) and the Timed Up and Go test (TUG). The isometric muscular strengths of bilateral knee extensors and flexors were measured using an isokinetic dynamometer. Cardiovascular fitness was evaluated using an expired gas analyzer. Participants were assigned into the household ambulator group (<0.4 m/s) or the community ambulator group (≥0.4 m/s) based on gait severity.
  
  
  RESULTS
  In the linear regression analyses of all patients, paretic knee isometric extensor strength (p=0.007) and BBS (p<0.001) were independent predictors of gait endurance (R(2)=0.668). TUG (p<0.001) and BBS (p=0.037) were independent predictors of gait speed (R(2)=0.671). Paretic isometric extensor strength was a predictor of gait endurance (R(2)=0.340, p=0.008). TUG was a predictor of gait speed (R(2)=0.404, p<0.001) in the household ambulator group, whereas BBS was a predictive factor of gait endurance (R(2)=0.598, p=0.008) and speed (R(2)=0.713, p=0.006). TUG was a predictor of gait speed (R(2)=0.713, p=0.004) in the community ambulator group.
  
  
  CONCLUSIONS
  Our results reveal that balance function and knee extensor isometric strength were strong predictors of ambulatory function in subacute stroke patients. However, they work differently according to gait severity. Therefore, a comprehensive functional assessment and a different therapeutic approach should be provided depending on gait severity in subacute stroke patients.
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Chul Woong
authors.initials: CW
authors.lastname: Hyun
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Han
authors.affiliation: Department of Rehabilitation Medicine, CHA Bundang Hospital, Seongnam, Korea.
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Im
authors.affiliation: Department of Neurology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Jay Chol
authors.initials: JC
authors.lastname: Choi
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Bo Ryun
authors.initials: BR
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Ho Min
authors.initials: HM
authors.lastname: Yoon
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Yong Ki
authors.initials: YK
authors.lastname: Lee
keywords: Balance; Gait; Muscle strength; Physical fitness; Stroke