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Walking speed as a predictor of community mobility and quality of life after stroke
Authors:Montserrat Grau-Pellicer  Andrés Chamarro-Lusar  Josep Medina-Casanovas  Bernat-Carles Serdà Ferrer
Institution:1. Rehabilitation Unit, Hospital-Consorci Sanitari de Terrassa, Barcelona, Spain;2. Physical Therapy Department, Autonomous University of Barcelona, Barcelona, Spain;3. Basic, Evolutionary, and Educational Psychology Department, Autonomous University of Barcelona, Barcelona, Spain;4. Physical Therapy Department, Autonomous University of Barcelona, Barcelona, Spain;5. Functional Rehabilitation Department, Private Foundation Institut Guttmann Neurorehabilitation Hospital, Badalona, Barcelona, Spain. Physical Therapy Department, Autonomous University of Barcelona, Barcelona, Spain;6. Department of Nursing, and Biomedical Research Institute, University of Girona, Girona, Spain
Abstract:Background: Community mobility (CM) is considered a part of community reintegration that enhances Quality of Life (QoL). Achieving an appropriate gait speed is essential in attaining an independent outdoor ambulation and satisfactory CM.

Objective: The aim of this study was to identify whether gait speed is a predictor of CM and QoL in patients with stroke following a multimodal rehabilitation program (MRP).

Methods: This was a baseline control trial with 6-months follow-up in an outpatient rehabilitation setting at a university hospital. Twenty-six stroke survivors completed the MRP (24 sessions, 2 days/wk, 1 hr/session). The MRP consisted of aerobic exercise, task-oriented exercises, balance exercises and stretching. Participants also performed an ambulation program at home. Outcome variables were: walking speed (10-m walking test) and QoL (physical and psychosocial domains of Euroquol and Sickness Impact Profile).

Results: At the end of the intervention, comfortable and fast walking speed increased by an average of 0.16 (SD 0.21) (*p < .05) and 0.40 (SD 0.51) (**p < .001) m/s, respectively. After the intervention, all participants achieved independent outdoor ambulation with an increase of 34.14 of walking minutes/day in the community and a decrease of sitting time of 95.45 minutes/day. Regarding QoL there were increased mean scores on the physical and psychosocial dimensions of Euroquol and the Sickness Impact Profile, respectively (**p < .001).

Conclusions: The results suggest that improved walking speed after the MRP is associated with CM and higher scores in QoL. These findings support the need to implement rehabilitation programs to promote increased speed.

Keywords:Stroke  rehabilitation  gait speed  community mobility  quality of life
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