Responsiveness and predictability of gait speed and other disability measures in acute stroke
Responsiveness and predictability of gait speed and other disability measures in acute stroke
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DOI：
10.1053/apmr.2001.24907
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发表时间：
2001-09-01
影响因子：
4.3
通讯作者：
Richards, CL
中科院分区：
文献类型：
--
作者：
Salbach, NM;Mayo, NE;Richards, CL
目的：确定测量步态速度最灵敏的方法，估计其他结果测量的响应性，并确定步态速度是否可以预测急性中风的出院目的地。设计：一项前瞻性队列研究。设置：五家急症护理医院。患者：50 名首次中风后有残余步态缺陷的受试者。干预措施：以舒适和最大速度进行 5 米步行测试 (5 mWT) 和 10 米步行测试 (10 mWT)，进行 2 次评估中风后 8 +/- 3 和 38 +/- 5 天的平均 +/- 标准差 (SD)。 主要结果测量：标准化反应平均值（SRM = 变化的平均变化/SD）用于估计每次步行测试的反应性、Berg 平衡量表、Barthel 指数、中风康复运动评估 (STREAM) 和计时起立行走 (TUG)。结果：SRM 为 1.22 和5mWT 为 1.00，10mWT 为 0.92 和 0.83，分别以舒适配速和最大配速进行。 Berg 平衡量表、Barthel 指数、STREAM 和 TUG 的 SRM 分别为 1.04、0.99、0.89 和 0.73。首次评估时行走速度小于或等于 0.3m/s 或 > 0.6m/s 的人被送往康复中心的概率分别为 0.95 和 0.22。结论：对于需要检测中风后前 5 周内步行障碍纵向变化的临床医生和研究人员，建议将舒适配速的 5mWT 作为首选测量方法。
Objectives: To identify the most responsive method of measuring gait speed, to estimate the responsiveness of other outcome measures, and to determine whether gait speed predicts discharge destination in acute stroke.Design: A prospective cohort study.Setting: Five acute-care hospitals.Patients: Fifty subjects with residual gait deficits after a first-time stroke.Interventions: Five- (5mWT) and 10-meter walk tests (10mWT) at comfortable and maximum speeds, with 2 evaluations conducted an average +/- standard deviation (SD) of 8 +/- 3 and 38 +/- 5 days poststroke.Main Outcome Measure: Standardized response mean (SRM = mean change/SD of change) was used to estimate responsiveness for each walk test, the Berg Balance Scale, the Barthel Index, the Stroke Rehabilitation Assessment of Movement (STREAM), and the Timed Up and Go (TUG).Results: The SRMs were 1.22 and 1.00 for the 5mWT, and .92 and .83 for the 10mWT performed at a comfortable and maximum pace, respectively. The SRMs for the Berg Balance Scale, the Barthel Index, the STREAM, and the TUG were 1.04, .99, .89, and .73, respectively. The probability of discharge to a rehabilitation center for persons walking at less than or equal to 0.3m/s or > 0.6m/s at the first evaluation was .95 and .22, respectively.Conclusions: The 5mWT at a comfortable pace is recommended as the measure of choice for clinicians and researchers who need to detect longitudinal change in walking disability in the first 5 weeks poststroke.