Citation

Karttunen AH, Kallinen M, Peurala SH, Häkkinen A. PM R 2015; 7(12): 1205-1214.

Affiliation

University of Jyvaskyla, Department of Health Sciences and Department of Rehabilitation Medicine, and Central Hospital, Jyvaskyla, Finland, Professor.

Copyright

(Copyright © 2015, American Academy of Physical Medicine and Rehabilitation, Publisher Elsevier Publishing)

DOI

10.1016/j.pmrj.2015.06.444

PMID

26164351

Abstract

OBJECTIVE: To determine if 65 to 85-year-old individuals 3-36 months post-stroke can improve functioning and quality of life during walking rehabilitation.

DESIGN: Prospective cohort study with 6-month follow-up. SETTING: Either an inpatient (three rehabilitation centers) or outpatient (one rehabilitation center). PARTICIPANTS: 147 individuals with stroke. INTERVENTION: The multidisciplinary rehabilitation intervention comprised inpatient (20 days) or outpatient (18 days) rehabilitation with follow-up. Rehabilitation included walking exercises with and without body-weight support and conventional physiotherapy. After the rehabilitation period, participants received 10-15 individual physiotherapy sessions at outpatient clinics and guidance in home exercises. MEASUREMENTS: 6-Minute Walking Test (6MWT), Berg Balance Scale (BBS), Assessment of Motor and Process Skills (AMPS), Functional Status Questionnaire (FSQ), Functional Independence Measure (FIM), WHO Quality of Life (WHOQOL-BREF), and Sense of Coherence (SOC-13) administered at the beginning of rehabilitation and at 6-month follow-up.

RESULTS: Walking distance (6MWT) improved by 17 ± 51 meters (p<.001). AMPS motor scale improved by 0.15 ± 0.65 logits (p=.010), process scale by 0.10 ± 0.46 logits (p=.012), and FSQ self-care by 2.8 ± 15.8 scores (p=.039). The changes in the total (4.2 ± 9.0), motor (3.7 ± 8.0) and cognitive (0.5 ± 2.0,) scores of the FIM were statistically significant (p<.01). BBS, WHOQOL-BREF and SOC-13 remained unchanged.

CONCLUSIONS: Walking distance and both self-reported and measured functioning improved during walking rehabilitation among elderly individuals with stroke. Maintaining or improving of functioning through rehabilitation and self-administered exercises may be important in supporting mobility and independent living outside institutional care.

Language: en