title: Short-time weight-bearing capacity assessment for non-ambulatory patients with subacute stroke: reliability and discriminative power.
abstract: BACKGROUND
  Weight-bearing capacity (WBC) on the hemiparetic leg is crucial for independent walking, and is thus an important outcome to monitor after a stroke. A specific and practical assessment in non-ambulatory patients is not available. This is of importance considering the increasing administration of high intensive gait training for the severely impaired stroke population. The aim was to develop a fast and easy-to-perform assessment for WBC on a foot pressure plate to be used in clinical routine.
  
  
  METHODS
  WBC was assessed in the frontal plane in 30 non-ambulatory patients with subacute stroke and 10 healthy controls under 3 conditions: static, dynamic, and rhythmic. Force-time curves for the hemiparetic leg (patients with stroke) and the non-dominant leg (healthy controls) were normalised as a percentage of body weight (%BW), and the means analysed over 60, 30, and 15 s (static) and the mean of the peak values for 15, 10, 5, 4, and 3 repetition trials (dynamic, rhythmic). The data were tested for discriminative power and reliability. Dynamic and rhythmic tests could discriminate between patients with stroke and healthy controls over all periods (15, 10, 5, 4, and 3 repetitions) (p < 0.001), but not the static test (60 s, p = 0.639; 30 s, p = 0.708; 15 s, p = 0.685). Excellent relative intra-session [intra-class correlation (ICC) >0.829] and inter-session reliability (ICC = 0.740) were found for 3 repetitions in the dynamic test with acceptable absolute reliability [standard error of measurement (SEM) <5 %BW, minimal detectable difference (MDD) <12.4 %BW] and no within- or between-test differences (trial 1, p = 0.792; trial 2, p = 0.067; between trials, p = 0.102).
  
  
  CONCLUSIONS
  Three dynamic repetitions of loading the hemiparetic leg are sufficient to assess WBC in non-ambulatory patients with subacute stroke. This is an important finding regarding the implementation of a fast and easy-to-perform assessment for routine clinical usage in patients with limited standing ability.
authors.affiliation: Division of Mechanical Engineering, Department of Engineering and Information Technology, Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Pestalozzistrasse 20, 3400, Burgdorf, Switzerland. stolleroliver@gmail.com.|Research Department, Reha Rheinfelden, Salinenstrasse 98, 4310, Rheinfelden, Switzerland. stolleroliver@gmail.com.
authors.forename: Oliver
authors.initials: O
authors.lastname: Stoller
authors.affiliation: Physiotherapy Department, Reha Rheinfelden, Salinenstrasse 98, 4310, Rheinfelden, Switzerland. h.rosemeyer@bluewin.ch.
authors.forename: Heike
authors.initials: H
authors.lastname: Rosemeyer
authors.affiliation: Division of Health, Applied Research and Development Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland. heiner.baur@bfh.ch.
authors.forename: Heiner
authors.initials: H
authors.lastname: Baur
authors.affiliation: Division of Mechanical Engineering, Department of Engineering and Information Technology, Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Pestalozzistrasse 20, 3400, Burgdorf, Switzerland. matthias.schindelholz@bfh.ch.|Research Department, Reha Rheinfelden, Salinenstrasse 98, 4310, Rheinfelden, Switzerland. matthias.schindelholz@bfh.ch.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schindelholz
authors.affiliation: Division of Mechanical Engineering, Department of Engineering and Information Technology, Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Pestalozzistrasse 20, 3400, Burgdorf, Switzerland. kenneth.hunt@bfh.ch.|Research Department, Reha Rheinfelden, Salinenstrasse 98, 4310, Rheinfelden, Switzerland. kenneth.hunt@bfh.ch.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Hunt
authors.affiliation: Division of Health, Applied Research and Development Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland. lorenz.radlinger@bfh.ch.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Radlinger
authors.affiliation: Division of Mechanical Engineering, Department of Engineering and Information Technology, Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Pestalozzistrasse 20, 3400, Burgdorf, Switzerland. c.schuster@reha-rhf.ch.|Research Department, Reha Rheinfelden, Salinenstrasse 98, 4310, Rheinfelden, Switzerland. c.schuster@reha-rhf.ch.
authors.forename: Corina
authors.initials: C
authors.lastname: Schuster-Amft
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology*; D016474:Weight-Bearing