Does gait analysis change clinical decision-making in poststroke patients? Results from a pragmatic prospective observational study

M. Ferrarin, M. Rabuffetti, M. Bacchini, A. Casiraghi, A. Castagna, A. Pizzi, A. Montesano

Research output: Contribution to journalArticle

Abstract

Background: Gait analysis (GA) was demonstrated to change presurgical planning and improve gait outcomes in children with Cerebral Palsy. GA is often used also to assess walking capability of poststroke subjects, although its influence in the clinical management of these patients has not yet been established. Objective: To assess the impact of GA on clinical decision-making in adult chronic poststroke patients. Design: Pragmatic prospective observational study. Setting: Rehabilitation hospital, both outpatients and inpatients. Population: Forty-nine patients (age: 53.3±14.5 years) who had had a cerebrovascular accident 35.2±26.4 months before and were referred to the gait analysis service. Methods: Recommendations of therapeutic treatments before and after the analysis of GA data were compared, together with the confidence level of recommendations on a 10-point scale. Frequency of changes of post-GA vs pre-GA recommendations were computed for each recommendation type: surgery, botulinum toxin (BT), orthotic management and physiotherapy. Results: Based on the analysis of GA data, 71% of post-stroke subjects had their treatment planning changed in some components. Indeed, 73% of patients with indications for surgery had their surgical planning changed; 81%, 37% and 32% had, respectively, their BT, orthotic and physiotherapy planning changed. Confidence level of recommendations increased significantly after GA, in both the whole group of patients (from 6.7±1.4 to 8.7±0.6, P

Original languageEnglish
Pages (from-to)171-184
Number of pages14
JournalEuropean Journal of Physical and Rehabilitation Medicine
Volume51
Issue number2
Publication statusPublished - Apr 1 2015

Keywords

  • Biomedical
  • Decision making
  • Gait
  • Rehabilitation
  • Stroke
  • Technology assessment

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

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