Fast gait speed and self-perceived balance as valid predictors and discriminators of independent community walking at 6 months post-stroke - a preliminary study

Purpose: To determine the validity of walking speed, muscle strength, function of the hemiparetic lower limb and self-perceived balance to predict and discriminate independent community walkers (ICW) within the first 6 months post-stroke. Methods: Inpatients with a first ischemic stroke (53 months), able to walk, were evaluated (T-0) and re-evaluated after 6 months post-stroke (T-1). Comfortable, fast speed and the difference between fast and comfortable speed, muscle strength of knee flexors and extensors, sensory-motor function of the hemiparetic lower limb and self-perceived balance were assessed at T-0 and T-1. At T-1, a self-reported question was used to discriminate ICW versus Dependent Community Walkers (DCW). ROC curve analysis was used to determine valid predictive (T-0) and discriminative (T-1) cut-offs of ICW. Results: Only 25.7% of the 35 participants were ICW at T-1. Valid predictive cut-offs at T-0 were found for fast speed (>= 0.42 m/s) and Falls Efficacy Scale (<57). Valid discriminators were found at T1 for fast speed (>0.84 m/s) and FES (<18.50). Conclusion: Fast speed and self-perceived balance appear to be important characteristics of ICW at 6 months and may be useful early predictors of the potential for patients to achieve this. Further research is needed to ensure the precision of these functional cut-offs.