Community ambulation of stroke survivors at 6 months follow-up: an observational study on sociodemographic and sub-acute clinical indicators

Italian Study Group on Implementation of Stroke Care (ISC Study)

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Despite the importance of walking recovery in real life contexts, only 7% of stroke survivors at discharge from neuro-rehabilitation units recover independent walking in the community. However, studies on outcome indicators of walking ability restoration following stroke rarely regard the community ambulation.

AIM: To investigate how socio-demographic and sub-acute clinical characteristics of stroke survivors at admission and at discharge may predict a good participation in community walking activity 6 months post-stroke.

DESIGN: Retrospective observational study.

SETTING: Inpatient neuro-rehabilitation centres.

POPULATION: Three-hundred-ten stroke survivors.

METHODS: A secondary analysis were performed on collected socio-demographic and clinical data of subjects after first-ever stroke within 72-hours of admission to acute care facilities (T1), at discharge (T2), and subsequently after 6-months post-stroke (T3). The regression analysis between every independent variable at T1 and T2 and Walking Handicap Scale-WHS (negative: 1-3; positive: 4-6) assessed at T3 were performed to identify the most important early predictors.

RESULTS: At T1, being younger, having a good ability to walk, early mobilization out of bed, not having TACI, and being female are significant positive indicators while, clinical complications are significantly negative for a WHS:4-6 at T3. No correlation were found between WHS and gender, aetiology, the side of lesion, the presence of aphasia, and the presence of risk factors. The combination of risk factors indicates a negative WHS at T3.

CONCLUSIONS: The presence of risk factors and clinical complications delay significantly the walking ability restoration and return to social life. Such status consistently with the patient's compliance must not postpone the rehabilitation relatively, rehabilitation must be facilitated with targeted programs taking care particularly of people with negative indicators for recovery of community ambulation 6 months post-stroke.

CLINICAL REHABILITATION IMPACT: Early indicators are considerable in order to predict a targeted prognosis and better provide a tailored rehabilitation program.

Original languageEnglish
JournalEuropean Journal of Physical and Rehabilitation Medicine
DOIs
Publication statusE-pub ahead of print - Dec 13 2018

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Walking
Observational Studies
Survivors
Stroke
Rehabilitation
Aptitude
Demography
Early Ambulation
Rehabilitation Centers
Aphasia
Patient Compliance
Inpatients
Retrospective Studies
Regression Analysis
Outcome Assessment (Health Care)

Cite this

Community ambulation of stroke survivors at 6 months follow-up : an observational study on sociodemographic and sub-acute clinical indicators. / Italian Study Group on Implementation of Stroke Care (ISC Study).

In: European Journal of Physical and Rehabilitation Medicine, 13.12.2018.

Research output: Contribution to journalArticle

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title = "Community ambulation of stroke survivors at 6 months follow-up: an observational study on sociodemographic and sub-acute clinical indicators",
abstract = "BACKGROUND: Despite the importance of walking recovery in real life contexts, only 7{\%} of stroke survivors at discharge from neuro-rehabilitation units recover independent walking in the community. However, studies on outcome indicators of walking ability restoration following stroke rarely regard the community ambulation.AIM: To investigate how socio-demographic and sub-acute clinical characteristics of stroke survivors at admission and at discharge may predict a good participation in community walking activity 6 months post-stroke.DESIGN: Retrospective observational study.SETTING: Inpatient neuro-rehabilitation centres.POPULATION: Three-hundred-ten stroke survivors.METHODS: A secondary analysis were performed on collected socio-demographic and clinical data of subjects after first-ever stroke within 72-hours of admission to acute care facilities (T1), at discharge (T2), and subsequently after 6-months post-stroke (T3). The regression analysis between every independent variable at T1 and T2 and Walking Handicap Scale-WHS (negative: 1-3; positive: 4-6) assessed at T3 were performed to identify the most important early predictors.RESULTS: At T1, being younger, having a good ability to walk, early mobilization out of bed, not having TACI, and being female are significant positive indicators while, clinical complications are significantly negative for a WHS:4-6 at T3. No correlation were found between WHS and gender, aetiology, the side of lesion, the presence of aphasia, and the presence of risk factors. The combination of risk factors indicates a negative WHS at T3.CONCLUSIONS: The presence of risk factors and clinical complications delay significantly the walking ability restoration and return to social life. Such status consistently with the patient's compliance must not postpone the rehabilitation relatively, rehabilitation must be facilitated with targeted programs taking care particularly of people with negative indicators for recovery of community ambulation 6 months post-stroke.CLINICAL REHABILITATION IMPACT: Early indicators are considerable in order to predict a targeted prognosis and better provide a tailored rehabilitation program.",
author = "{Italian Study Group on Implementation of Stroke Care (ISC Study)} and Sanaz Pornajaf and Michela Goffredo and Maurizio Agosti and Maurizio Massucci and Salvatore Ferro and Marco Franceschini",
year = "2018",
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language = "English",
journal = "European Journal of Physical and Rehabilitation Medicine",
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T1 - Community ambulation of stroke survivors at 6 months follow-up

T2 - an observational study on sociodemographic and sub-acute clinical indicators

AU - Italian Study Group on Implementation of Stroke Care (ISC Study)

AU - Pornajaf, Sanaz

AU - Goffredo, Michela

AU - Agosti, Maurizio

AU - Massucci, Maurizio

AU - Ferro, Salvatore

AU - Franceschini, Marco

PY - 2018/12/13

Y1 - 2018/12/13

N2 - BACKGROUND: Despite the importance of walking recovery in real life contexts, only 7% of stroke survivors at discharge from neuro-rehabilitation units recover independent walking in the community. However, studies on outcome indicators of walking ability restoration following stroke rarely regard the community ambulation.AIM: To investigate how socio-demographic and sub-acute clinical characteristics of stroke survivors at admission and at discharge may predict a good participation in community walking activity 6 months post-stroke.DESIGN: Retrospective observational study.SETTING: Inpatient neuro-rehabilitation centres.POPULATION: Three-hundred-ten stroke survivors.METHODS: A secondary analysis were performed on collected socio-demographic and clinical data of subjects after first-ever stroke within 72-hours of admission to acute care facilities (T1), at discharge (T2), and subsequently after 6-months post-stroke (T3). The regression analysis between every independent variable at T1 and T2 and Walking Handicap Scale-WHS (negative: 1-3; positive: 4-6) assessed at T3 were performed to identify the most important early predictors.RESULTS: At T1, being younger, having a good ability to walk, early mobilization out of bed, not having TACI, and being female are significant positive indicators while, clinical complications are significantly negative for a WHS:4-6 at T3. No correlation were found between WHS and gender, aetiology, the side of lesion, the presence of aphasia, and the presence of risk factors. The combination of risk factors indicates a negative WHS at T3.CONCLUSIONS: The presence of risk factors and clinical complications delay significantly the walking ability restoration and return to social life. Such status consistently with the patient's compliance must not postpone the rehabilitation relatively, rehabilitation must be facilitated with targeted programs taking care particularly of people with negative indicators for recovery of community ambulation 6 months post-stroke.CLINICAL REHABILITATION IMPACT: Early indicators are considerable in order to predict a targeted prognosis and better provide a tailored rehabilitation program.

AB - BACKGROUND: Despite the importance of walking recovery in real life contexts, only 7% of stroke survivors at discharge from neuro-rehabilitation units recover independent walking in the community. However, studies on outcome indicators of walking ability restoration following stroke rarely regard the community ambulation.AIM: To investigate how socio-demographic and sub-acute clinical characteristics of stroke survivors at admission and at discharge may predict a good participation in community walking activity 6 months post-stroke.DESIGN: Retrospective observational study.SETTING: Inpatient neuro-rehabilitation centres.POPULATION: Three-hundred-ten stroke survivors.METHODS: A secondary analysis were performed on collected socio-demographic and clinical data of subjects after first-ever stroke within 72-hours of admission to acute care facilities (T1), at discharge (T2), and subsequently after 6-months post-stroke (T3). The regression analysis between every independent variable at T1 and T2 and Walking Handicap Scale-WHS (negative: 1-3; positive: 4-6) assessed at T3 were performed to identify the most important early predictors.RESULTS: At T1, being younger, having a good ability to walk, early mobilization out of bed, not having TACI, and being female are significant positive indicators while, clinical complications are significantly negative for a WHS:4-6 at T3. No correlation were found between WHS and gender, aetiology, the side of lesion, the presence of aphasia, and the presence of risk factors. The combination of risk factors indicates a negative WHS at T3.CONCLUSIONS: The presence of risk factors and clinical complications delay significantly the walking ability restoration and return to social life. Such status consistently with the patient's compliance must not postpone the rehabilitation relatively, rehabilitation must be facilitated with targeted programs taking care particularly of people with negative indicators for recovery of community ambulation 6 months post-stroke.CLINICAL REHABILITATION IMPACT: Early indicators are considerable in order to predict a targeted prognosis and better provide a tailored rehabilitation program.

U2 - 10.23736/S1973-9087.18.05489-8

DO - 10.23736/S1973-9087.18.05489-8

M3 - Article

C2 - 30543267

JO - European Journal of Physical and Rehabilitation Medicine

JF - European Journal of Physical and Rehabilitation Medicine

SN - 1973-9087

ER -