Document Detail

Mobility beyond the clinic: the effect of environment on gait and its measurement in community-ambulant stroke survivors.
MedLine Citation:
PMID:  18511535     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To explore the impact of a complex community environment on gait parameters (speed, step length and cadence) for community-dwelling participants with a previous stroke, and compare outcome measures commonly used in a clinical environment. DESIGN: Repeated measurement of participants in different environments. SETTING: One clinic and two community environments (suburban street and shopping mall). SUBJECTS: Thirty community-dwelling stroke participants with chronic stroke who were classified according to gait speed (20-50 m/min on 10-metre timed walk) as marginal community walkers. OUTCOME MEASURES: During a six-minute walk test (6MWT) a step activity monitor (SAM) and odometer were used to calculate gait speed, step length and cadence. The 10-metre timed walk (10MTW) was measured in a clinic environment. ANALYSIS: A mixed linear model examined differences in gait measurements in the different environments. Bland-Altman analysis illustrated agreement between gait speed measures (6MWT and 10MTW). RESULTS: A statistically significant, but not a clinically significant difference in gait speed between some environments was found. Gait speed was slowest in the mall and fastest in the street with a difference of only 2.1 m/min between these environments (95% confidence interval (CI) -3.8 to -0.5, P<0.01). Comparison of clinic 10MTW and street 6MWT showed wide limits of agreement (-18.5 to 16.9 m/min) which improved for clinic 6MWT and street 6MWT comparisons (-5.7 to 8.9 m/min). CONCLUSION: Despite residual gait deficit, the gait parameters of these chronic stroke survivors did not deteriorate markedly under challenging conditions. The 6MWT is recommended as a clinical measure for community ambulation.
Kimberley Donovan; Susan E Lord; Harry K McNaughton; Mark Weatherall
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical rehabilitation     Volume:  22     ISSN:  0269-2155     ISO Abbreviation:  Clin Rehabil     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-30     Completed Date:  2008-09-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8802181     Medline TA:  Clin Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  556-63     Citation Subset:  IM    
School of Physiotherapy, Centre for Physiotherapy Research, University of Otago, New Zealand.
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MeSH Terms
Activities of Daily Living / psychology
Chronic Disease
Exercise Test*
Gait Disorders, Neurologic / rehabilitation
Middle Aged
Outcome Assessment (Health Care)
Recovery of Function
Residence Characteristics
Stroke / psychology,  rehabilitation*
Task Performance and Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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