6分钟步行实验在充血性心力衰竭患者的应用价值

目的：探讨6min步行实验在国人充血性心力衰竭患中的可行 及临床应用价值。方法：22例正常对照和50例CHP患进行了6min步行实验（6－MWT）,其中随机选取的12例患于第二日进行了重复实验,对未行手术治疗的40例患进行随访。／结果：6－MWT安全性及重复性良好。CHF患6min内步行距离明显短于正常对照（P＜0．001）,心功能II级患6min内步行距离明显长于心功能III,IV患（P＜0．001）,按照Vera Bitter报道的分级方法,Level 1,2患再入院时间明显长于Level 3,4患（P＜0．001）。结论：对于中国人中的CHF患,6min步行实验是一种简便,无创,便宜,安全,重复性良好的运动实验,具有可行性强及临床应用价值高的特点。     

严重肺气肿减容术前后运动能力及生活质量评价

目的：对晚期肺气肿患者减容术前后呼吸困难指数，运动能力，生活质量进行评估。方法：采用体容积描记仪，运动心肺功能及6min步行距离，并用简易的医学研究调查委员会呼吸困难评分标准及诺丁汉姆健康状况（NHP）对呼吸困难程度及生活质量进行评价，结果：术后3月，6月，12月与术前相比，用力肺活量（FVC）及第1s用力呼气量（FEV1）均增加（P＜0．001），6min步行距离（6－MWD）均提高（P＜0．001），NHP问卷Ⅰ及问卷Ⅱ评分均降低（P＜0．05），结论：晚期肺气肿患者行减容手术可明显改善其运动功能及生活质量。     

慢性阻塞性肺疾病患者6分钟步行实验与最大摄氧量关系研究

目的比较慢性阻塞性肺疾病(COPD)患者6分钟步行实验(6MWT)与最大摄氧量(VO2max)关系,进一步评价6分钟步行实验的客观性。方法 27例稳定期COPD(轻到极重度)患者进行心肺运动实验(CPET)测定、6MWT、静态肺功能测定,计算体重指数(BMI)。比较6MWT与VO2max相关性。结果VO2max/kg与6MWD呈正相关(r=0.821,P=0.000),得出与6MWD相关线性回归方程。结论 VO2max作为运动功能评定金标准,它与6MWT有较强相关性,进一步证实6MWT的可靠性。     

运动训练对老年慢性心力衰竭患者心功能及血清CysC浓度的影响

【目的】探讨运动训练对老年慢性心力衰竭（CHF）患者心功能和血清胱抑素C（CysC）浓度的影响。方法 172例心功能Ⅱ～Ⅲ级老年CHF患者随机分为训练组（n=36）和对照组（n=36）,入选后即行6分钟步行试验（6MwT）、检测CysC浓度、超声多普勒检测心功能。对照组常规给予抗心衰药物治疗,在此基础上训练组每天行2次6MWT运动强度的步行训练。8周后复查6MWT、血清CysC浓度、行超声多普勒检测心功能。【结果】两组患者6MWT距离心功能Ⅲ级患者均显著短于Ⅱ级患者（P〈O．05）,CysC水平Ⅲ级患者均显著高于Ⅱ患者（P〈O．05）。治疗8周后两组患者血清CysC浓度均有显著下降（P〈0．05）,6MWT距离明显增加（P〈0．01,P〈O．05）,心功能客观指标明显提高（P〈0．05）,但训练组改善程度显著优于对照组（P〈0．01）。【结论】运动训练可以显著提高老年CHF患者的运动能力并降低血清CysC浓度,改善心功能。     

曲美他嗪对老年缺血性心脏病并发糖尿病病人的效果

目的评价曲美他嗪辅助治疗老年缺血性心脏病并发糖尿病病人的效果。方法将66例老年缺血性心脏病并发糖尿病病人随机分为常规治疗组（n=33）和曲美他嗪组（n=33），治疗6个月后分别进行6min步行试验（6MWT）、超声心动图（USG）、空腹血糖和糖化血红蛋白检查。结果治疗后曲美他嗪组较常规治疗组心功能分级明显提高（u=2．134．P〈0．05）；同时6MWT的走距延长，左心室舒张末径及收缩末径减小，左心室射血分数提高（t=2．263，P〈0．05）。治疗前后两组间空腹血糖和糖化血红蛋白比较差异无显著性。结论曲美他嗪与其他治疗老年缺血性心脏病并发糖尿病病人的常规药物联用，可以进一步改善病人的心脏功能，增加心脏运动耐量。     

5分钟坐立试验评价慢性心力衰竭患者心功能的有效性研究

目的:评价5分钟坐立试验(5MSST)在慢性心力衰竭中的应用,以及5MSST与6分钟步行试验(6MWT)等其他心肺功能指标之间的相关性。方法:对30例健康对照组与30例慢性心衰组受试者的5MSST、6MWT进行分析研究;并比较这两种测试对受试者心率、收缩压、舒张压、Borg指数和血氧饱和度的影响。结果:慢性心衰组与健康对照组之间5min坐立次数和6min步行距离的差异均有显著性意义(P0.01)。5MSST和6MWT测试对慢性心衰患者的Borg指数均有明显影响(P0.01);而慢性心衰患者只有6MWT测试后心率、收缩压和血氧饱和度出现明显变化(P0.05)。慢性心衰组和健康对照组5MSST与6MWT之间的相关系数分别为0.76(P0.01),0.51(P0.01),具有显著差异。慢性心衰组患者5MSST与年龄和EF值之间的相关系数分别为-0.87(P0.01),-0.65(P0.01);6MWT与年龄和EF值之间的相关系数分别为-0.65(P0.01),-0.77(P0.01);健康对照组5MSST和6MWT与年龄之间的相关系数分别为-0.48(P0.01),-0.57(P0.01),具有显著性差异。结论:5MSST与6MWT呈显著正相关,并且对受试者心率、血压和氧饱和度等心肺活动指数影响较小,可以便捷、准确地评价慢性心力衰竭患者运动耐量,是一种值得推广的简便易行的心肺功能评估方法。     

运动治疗对老年冠心病患者冠脉介入治疗后运动耐力的影响

目的评价运动治疗对老年冠心病患者经皮冠状动脉介入治疗（PCI）后运动耐力的影响。 方法将成功进行PCI术后的老年冠心病患者42例随机分为康复组和对照组，每组21例。康复组行运动治疗3个月，运用6 min步行试验（6MWT）测定运动治疗前、后最大耗氧量（VO2max）、峰值心率、最大代谢当量、步行距离和每搏耗氧量。 结果康复组运动治疗3个月后分别与治疗前、对照组同期比较，VO2max、最大代谢当量、步行距离、每搏耗氧量均显著提高（P＜0.01），峰值心率显著减慢（P＜0.05）。 结论运动治疗有助于提高老年冠心病患者PCI术后心脏功能贮备和耐力。     

六分钟步行试验与摄氧量的相关性研究

背景:6 min步行试验是一种亚极量水平的运动试验,其操作简便、费用低廉,因而应用较广泛,然而将步行距离转换为最大运动能力是不易的.目的:课题组创新性地在6 min步行实验中引入做功的概念,将无线遥测呼吸气体分析仪同时应用于6 min步行试验和心肺运动试验,分析6 min步行试验中的距离、做功与峰值摄氧量与Bruce方案测得的最大摄氧量之间的相关性.设计、时间及地点:实验于2009-03/05在南京东南大学附属中大医院康复医学科完成.对象:健康受试者来自在中大医院康复医学科实习的学生,共25名,男14名,女11名;年龄(22.0±2.3)岁.方法:25名志愿者先按Bruce方案进行极量心肺运动试验,检测每位受试者极量运动时的最大摄氧量和无氧阈,再接受6 min步行试验,测量每位受试者的6 min步行距离、做功和峰值摄氧量.心肺运动试验和6 min步行试验均采用便携式K4b~2气体分析仪实时检测气体交换参数,以获得最大摄氧量和峰值摄氧量.主要观察指标:①摄氧量、心率、呼吸频率随时间的变化规律.②步行距离、做功、摄氧量、心率、呼吸频率的前后比较.③心肺运动试验中的最大摄氧量、无氧阈与6 min步行试验中的峰值摄氧量比较.④距离、做功与峰值摄氧量、最大摄氧量之间的相关性.结果:心肺运动试验测得的无氧阈与6 min步行试验测得的峰值摄氧量之间差异无显著性意义(P > 0.05).6 min步行距离与峰值摄氧量和最大摄氧量均无明显相关;6 min步行做功与峰值摄氧量呈线性相关(r=0.779 7,P < 0.001);6 min步行做功与最大摄氧量亦呈线性相关(r=0.894 1,P < 0.001).结论:6 min步行试验是一种无氧阈水平的运动试验.6 min步行做功既可反映受试者亚极量运动的能力,也能反映受试者极量运动的能力.     

家庭肺康复运动训练方案在慢性阻塞性肺病发展中作用的研究

目的：探讨一种简单的家庭肺康复运动训练方案是否能提高慢性阻塞性肺病（COPD）患者的运动能力，改善患者的生存质量。方法：19例COPD患者完成了6周简单的家庭肺康复训练，康复前后测患者的生存质量，6min步行距离（6MWD），静态肺功能，运动心肺功能，进行配对分析。结果：①患者肺康复运动训练6周后平均6MWD从384m增加到451m（P〈0．001）。②康复前患者心肺联合运动实验最大运动功率、峰值氧耗量、峰值二氧化碳排除量、峰值通气量、通气无氧阈、氧脉搏分别为55．36W、0．99L/min、0．84L/min、24．11L/min、0．73L/min、8．24ml／beat，康复后分别为60．57W、1．231L/min、1．03L／min、28．26L/min、0．92L/min、10．12ml／beat，前后比较差异有显著性意义（P〈0．05）。（3）CRQ的改善差异有显著性意义。（4）FEV1虽然从1．18L增加至1．22L，比较差异无显著性意义（P〉0．05）。结论：以6min步行距离作为患者运动康复的强度设置是可行的，方案提高了COPD患者的运动能力，改善其生存质量，且简单、经济。     

成人脑瘫患者6分钟步行试验步行距离的影响因素

目的:探究在成人脑瘫患者中不同生理因素及粗大运动功能对6min步行试验步行距离(6MWD)的影响。方法:将符合脑瘫诊断标准的55例患者纳入研究,分别测定身高(height)、体重(weight)、静息状态下的心率(RHR)和血压(BP),并使用粗大运动功能测定量表(GMFM)评定患者粗大运动功能总分(GMFM总),以及D和E功能区的分数(分别记为GMFM-D、GMFM-E),然后进行6min步行试验(6MWT),测定患者步行试验过程中的摄氧量(VO2总)、心率(HR步)以及6MWD,并计算出步行5m的速度(speed 5m)、每公斤体重摄氧量(VO2/kg)和步行每米摄氧量(VO2/m)。结果:成人脑瘫患者6MWD相关的因素主要包括RHR(r=-0.531,P0.05),VO2/m(r=-0.542,P0.05),VO2/kg(r=0.682,P0.001)、GMFM总(r=0.614,P0.01)、GMFM-D(r=0.538,P0.05)、GMFM-E(r=0.679,P0.001)和speed 5m(r=0.680,P0.001),其中GMFM-E(r=0.679,P0.001)、VO2/kg(r=0.682,P0.001)和speed 5m(r=0.680,P0.001)对6MWD具有显著影响,而height(r=0.01,P=0.81)、6MWT的HR(r=0.04,P=0.68)及BP(r=0.16,P=0.50)与6MWD结果无显著关联。结论:步行相关的粗大运动功能以及步行过程中有氧代谢水平是影响成人脑瘫患6MWD的主要因素。     

Intensity and daily reliability of the six-minute walk test in moderate chronic heart failure patients

OBJECTIVE: To assess the intensity and daily reliability of the six-minute walk test (6MWT) in patients with moderate chronic heart failure (CHF). DESIGN: Evaluation of testing protocol. SETTING: Hospitalized care. PARTICIPANTS: CHF patients under optimal drug treatment (CHF-D, n=12) or optimal drug treatment plus multisite cardiac pacing (CHF-P, n=12). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Peak values of oxygen uptake (VO2) and heart rate during a symptom-limited, treadmill exercise test and VO2, heart rate, and distance during 2 6MWT sessions (morning and afternoon). The 6MWT intensity was estimated by the ratio (%) of VO2 and heart rate values measured at the end of this test in relation to the respective peak values obtained during the treadmill exercise test. RESULTS: Subjects' VO2 and heart rate during the 6MWT were lower (P<.001) and were about 90% of the peak values (VO2: CHF-D, 90.5%+/-11.1%; CHF-P, 93.0%+/-13.2%; heart rate: CHF-D, 90.6%+/-6.6%; CHF-P, 91.4%+/-9.6%). The distance walked during both 6MWT sessions did not differ significantly, with low coefficients of variation (< or =2.0%) and high intraclass correlation coefficients (> or =.98). In CHF-D only, the patients' VO2 and heart rate were significantly (P<.01, P<.05, respectively) higher during the afternoon session. CONCLUSIONS: Despite an intensity significantly lower but close to that of the symptom-limited exercise test, the 6MWT was well tolerated in both CHF groups. In these populations, the 6MWT is reliable on a daily basis, for the distance walked. However, for assessing VO2 and heart rate values in CHF-D patients, the 6MWT must always be performed at the same time of day.     

The isokinetic assessment of peripheral muscle function in patients with coronary artery disease: correlations with cardiorespiratory capacity.

OBJECTIVE: We aimed to determine whether diminished cardiorespiratory capacity in patients with coronary artery disease (CAD) is accompanied by impaired skeletal muscle function as measured by isokinetic dynamometry. We also evaluated the correlation between isokinetic strength and aerobic capacity in these patients. MATERIALS AND METHODS: Fifteen CAD patients and 15 age-matched healthy subjects (mean age 60+/-6 vs. 57+/-3.5 years) underwent maximal laboratory exercise testing, a 6-min walking test and an assessment of peripheral skeletal muscle function by use of an isokinetic apparatus. Quadricep and hamstring function was tested at two angular velocities, 150 and 180 degrees s(-1) with simultaneous electrocardiography monitoring. The cardiorespiratory and mechanical parameters (VO(2), ventilatory threshold [VT], heart rate [HR], and power) were measured at VT and at maximal effort. RESULTS: Quadricep and hamstring peak torque was impaired in CAD patients, with quadriceps peak torque at 180 degrees being 71.13 +/- 14 vs. 91.13 +/- 23 Nm (P<0.01) and hamstring peak torque 46.50+/-10 vs. 59.86+/-12 Nm (P<0.01). CAD subjects presented a deficient aerobic capacity as compared with the healthy subjects at maximal effort. At VT, the VO(2), ventilation, and HR were significantly lower in CAD patients, at 13.77+/-2.33 vs. 17.08+/-3.59 ml min(-1) kg(-1) (P<0.05), 29.64 +/- 664 vs. 37.76 +/- 7.2 ml min(-1) (P<0.05), and 86+/-14 vs. 111+/-15 beats min(-1) (P=0.001), respectively. The 6-min walking distance was significantly shorter for CAD patients than healthy subjects (425.93+/-52.77 vs. 551.46 +/- 57.94 m; P<0.01). In CAD patients quadriceps and hamstring strength was not correlated with VO(2) at maximal effort and at VT. Total distance walked during the 6-min walk and VO(2)max were correlated (r=0.869; P<0.001) but not at VT. CONCLUSION: CAD patients showed impaired cardiorespiratory capacity accompanied by increased muscle fatigability as compared with healthy subjects. An isokinetic muscle assessment in these patients must be achieved systematically and seems to have value in cardiovascular rehabilitation.     

The impact of physical activity level,degree of dyspnoea and pulmonary function on the performance of healthy young adults during exercise

BackgroundIn addition to being simple and requiring minimal technology, the 6-min walk test (6MWT) has been found to be reproducible and well tolerated since its first use. However, the impact of non-anthropometric factors on functional capacity is less clear in healthy young adults because the majority experience no age-related changes in the locomotor system or associated comorbidities.AimTo identify the effect of physical activity level, degree of dyspnoea and pulmonary function on functional capacity, evaluated through the 6-min walking distance (6MWD) of healthy young adults, in order to prevent clinical abnormalities.MethodThis is a cross-sectional study including 190 healthy young adults who were subjected to the 6MWT to assess walking distance and degree of dyspnoea using the Borg scale. Furthermore, pulmonary function using spirometry and physical activity level using the International Physical Activity Questionnaire (IPAQ) were assessed. According to the IPAQ, the subjects were categorised as sedentary, irregularly active or active.ResultsThe 6MWD was positively correlated with pulmonary function parameters (P ≤ 0.002 for all parameters). There was a marginally significant correlation between the 6MWD and the difference between the scores assessed before and after the test using the Borg scale. There was a trend towards significant differences in 6MWD according to the IPAQ categories. Furthermore, forced vital capacity was the only pulmonary function parameter with significant differences between IPAQ categories (P = 0.02).ConclusionIn healthy young adults, greater pulmonary function indicates a greater 6MWD. In these subjects, physical activity level based on the IPAQ categories clearly affects pulmonary function. However, the IPAQ category and degree of dyspnoea are poorly related to the 6MWD of these subjects.     

有氧运动对中年女性心肺功能和血管内皮功能的影响及其与雌激素的关系

目的:明确有氧运动对中年女性心肺功能的提高是否与血管内皮功能的改善有关,以及心肺功能的提高程度是否受女性雌激素水平的影响。方法:前瞻性募集51名45~55岁健康女性,随机分为运动组(31名,其中15名已绝经)和对照组(20名),运动组进行12周中等强度有氧运动,对照组不进行运动干预。运动心肺功能测试以PVO2反映心肺功能,ELISA测量血浆ADMA和NOS水平评价内皮功能,同时观察血浆雌二醇水平等。结果:运动12周后,运动组PVO2及NOS均较运动前及对照组有显著提高(P0.05),ADMA较运动前及对照组明显下降(P0.05),而E2、体重指数在运动前后及对照组比较均差异无统计学意义;对照组运动干预前后各项指标比较差异无统计学意义。有氧运动组中绝经者与未绝经者上述指标测值均无明显差异。Pearson相关分析显示运动前后PVO2的提高程度与血管内皮功能的改善程度有显著相关性(r=0.339,P=0.023),与ADMA显著负相关(r=0.333,P=0.025),而PVO2和内皮功能的程度均与基线雌激素水平无相关性。结论:有氧运动训练可以显著提高健康中年女性的心肺功能和改善其血管内皮功能,推测心肺功能的提高可能与内皮功能的改善有关;而内皮功能的改善并不依赖于受试者的基础雌激素水平,提示绝经前及绝经后女性均能从运动中得到相同的获益。     

Value of Impedance Cardiography during 6‐Minute Walk Test in Pulmonary Hypertension

Background

Methods that predict prognosis and response to therapy in pulmonary hypertension (PH) are lacking. We tested whether the noninvasive estimation of hemodynamic parameters during 6‐minute walk test (6MWT) in PH patients provides information that can improve the value of the test.

Methods

We estimated hemodynamic parameters during the 6MWT using a portable, signal‐morphology‐based, impedance cardiograph (PhysioFlow Enduro) with real‐time wireless monitoring via a bluetooth USB adapter.

Results

We recruited 48 subjects in the study (30 with PH and 18 healthy controls). PH patients had significantly lower maximum stroke volume (SV) and CI and slower cardiac output (CO) acceleration and decelerations slopes during the test when compared with healthy controls. In PH patients, CI change was associated with total distance walked (R = 0.62; P < 0.001) and percentage of predicted (R = 0.4, P = 0.03), HR recovery at 1 minute (0.57, P < 0.001), 2 minutes (0.65, P < 0.001), and 3 minutes (0.66, P < 0.001). Interestingly, in PH patients CO change during the test was predominantly related to an increase in SV instead of HR.

Conclusions

Estimation of hemodynamic parameters such as cardiac index during 6‐minute walk test is feasible and may provide useful information in patients with PH. Clin Trans Sci 2013; Volume #: 1–7     

Arm span as a predictor of the six-minute walk test in healthy children

BackgroundSix-minute walk test (6MWT) is the most used test to assess functional capacity. Including arm span in the prediction equations for 6MWT performance might be an alternative for use in traditional reference equations.ObjectiveThe aim was to investigate the usability of arm span to predict the 6MWT distance in healthy children.Methods262 healthy children aged between 6 and 12 years old participated in this study. 6MWT was conducted according to the standardized protocol. Height, weight, and arm span were measured before performing the 6MWT. A multiple stepwise linear regression analysis was used to generate the regression model.ResultsThe 6MWT distance had strong positive correlations with age, arm span, height, and weight (p < 0.001). There was also a very strong correlation between arm span and height (p < 0.001). Age and arm span were found as significant predictors in the first regression model. These two variables explained 60.2% of the variance in the 6MWT distance. Age and height were also found as significant predictors, explaining 60.5% of the variance in the 6MWT distance. The two following formula were obtained to predict the 6MWT distance: (?23.09 + (31.12 × Age) + (2.39 × Arm span)) or (?80.0 + (28.98 × Age) + (2.92 × Height)).ConclusionsThe results suggest that the combination of arm span (or height) and age are strong predictors of the 6MWT distance in healthy children.     

Six‐minute walk test in obese children and adolescents: Reproducibility and validity

Background and Purpose . The six‐minute walk test (6MWT) is increasingly used in clinical practice. The aims of this study were to determine the reproducibility of the 6MWT in obese children and adolescents, to describe walking capacity in this population and compare the results with values from normal‐weight children (known group validity), and, finally, to describe the correlation between distance walked and estimated maximum oxygen uptake (VO₂max). Methods . Reproducibility was determined by a test–retest design and known group validity by a comparative design. The 6MWT was first test–retested in 49 obese children (30 boys, 19 girls, 8–16 years, body mass index [BMI] 24.9–52.1 kg?m^?2). Then, for validation, 250 obese children (126 boys, 124 girls, 8–16 years, BMI 23.2–57 kg/m²) and 97 normal‐weight children (48 boys, 49 girls, 8–16 years, BMI 13.3–23.2 kg·m^?2) performed the 6MWT. The obese children also performed a sub‐maximal bicycle ergometry test. Results . In the test–retest, the obese children walked 571 m the first test and 57 m the second (p = 0.578). The measurement error (S_w) was 24 m, coefficient of variation (CV): 4.3% and the intraclass correlation (ICC1:1): 0.84. Repeatability was 68 m, and limits of agreement were +71 and ?65 m. In comparison mean (standard deviation), six‐minute walk distance (6MWD) in the obese children was 571 m (65.5), and in the normal‐weight children, 663 m (61.1) (p < 0.001). The correlation between 6MWD and estimated VO₂max (r = 0.34) was low. Conclusions . The 6MWT showed good reproducibility and known group validity, and can be recommended for use in clinical practice in the studied population. To evaluate individual outcomes after intervention, the 6MWD needs to change by >68 m to be statistically significant. The 6MWD performed by obese children averaged 86% of the distance normal‐weight children walked. In obese children, the correlation between 6MWD and estimated VO₂max was low, hence the 6MWT cannot substitute a bicycle ergometry test. Copyright © 2008 John Wiley & Sons, Ltd.     

Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke

OBJECTIVE: To determine the reliability, concurrent and predictive validity, and responsiveness of the Functional Ambulation Category (FAC) in hemiparetic patients after stroke. DESIGN: Prospective cohort. SETTING: An early rehabilitation center for patients with neurologic disorders. PARTICIPANTS: Fifty-five nonambulatory patients after first-ever stroke, with duration of illness between 30 and 60 days, were included. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: FAC, Rivermead Mobility Index (RMI), walking velocity, step length, and six-minute walking test (6MWT) were assessed at the beginning, after 2 and 4 weeks of rehabilitation, and again 6 months later. After 6 months, community ambulation was also assessed. Test-retest and interrater reliability, concurrent, discriminant, and predictive validity and responsiveness of the FAC were calculated. RESULTS: Based on video examinations, high test-retest reliability (Cohen kappa=.950) and interrater reliability (kappa=.905) were found. FAC scores at the beginning and after 2 weeks, 3 weeks, and 6 months correlated highly with the RMI (Spearman rho=.686, rho=.787, rho=.825, rho=.893, respectively), distance walked in the 6MWT (rho=.949, rho=.937, rho=.931, rho=.906, respectively), walking velocity (rho=.952, rho=.939, rho=.902, rho=.901, respectively), and step length (rho=.952, rho=.932, rho=.896, rho=.877, respectively) at the same time points (all P<.001). The RMI, walking velocity, step length, and distance walked in the 6MWT differed for each FAC category (P<.001). After 4 weeks of rehabilitation, an FAC score of 4 or higher predicted community ambulation at 6 months with 100% sensitivity and 78% specificity. FAC scores changed significantly between the first 2 and second 2 weeks (Wilcoxon z=8.7, z=7.9, respectively; both P<.001) of the inpatient rehabilitation program. CONCLUSIONS: The FAC has excellent reliability, good concurrent and predictive validity, and good responsiveness in patients with hemiparesis after stroke.