Speed and Distance Requirements for Community Ambulation: A Systematic Review

Salbach, Nancy M.; O’Brien, Kelly K; Brooks, Dina; Irvin, Emma; Martino, Rosemary; Takhar, Pam; Chan, Sylvia; Howe, Jo-Anne

doi:10.1016/j.apmr.2013.06.017

Cited by 83 publications

(68 citation statements)

References 23 publications

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“…Further, improved gait endurance is associated with independence with community ambulation (Bijleveld-Uitman et al, 2013;van de Port et al, 2008). Theoretically, increased gait endurance will allow stroke survivors to ambulate within places of interest within the community (Salbach et al, 2014b;Andrews et al, 2010). Thus, improvements in gait endurance may result in stroke survivors ambulating without restrictions within their community and thus increased community ambulation.…”

Section: Walking Capacitymentioning

confidence: 99%

“…Distance, speed and functional requirements for successful community ambulation differ between communities, depending on location (Salbach et al, 2014b;Mudge and Monachino, 2013;Corrigan and McBurney, 2012;Andrews et al, 2010;Robinett and Vondran, 1988) and population density (Robinett and Vondran, 1988). Minimum gait speed requirements for successful independent community ambulation range from 0.8m/s (Hill et al, 1997;Perry et al, 1995) to 1.3m/s (Andrews et al, 2010;Lord and Rochester, 2005;Lord et al, 2004;Robinett and Vondran, 1988;Lerner-Frankiel et al, 1986), while minimum walking distance requirements range from 18m (Salbach et al, 2014b;Robinett and Vondran, 1988) to 677m (Salbach et al, 2014b;Andrews et al, 2010;Hill et al, 1997;Lerner-Frankiel et al, 1986) of stroke survivors achieved independent outdoor ambulation, despite only 7% achieving all clinical requirements indicative of independent community ambulation.…”

Section: Current Requirements and Criteria For Community Ambulationmentioning

confidence: 99%

“…Further, limitations in walking capacity may limit stroke survivors' in accessing places of interest within their communities (Salbach et al, 2014b;Shumway-Cook et al, 2005b;ShumwayCook et al, 2003). This may predispose stroke survivors to low levels of ambulation activity and community ambulation early after stroke.…”

Section: Walking Capacitymentioning

confidence: 99%

“…These may impose challenges for stroke survivors that may result in increased avoidance of difficult community locations (Robinson et al, 2013;Lord et al, 2010;Shumway-Cook et al, 2005a;Shumway-Cook et al, 2002). For example, larger shopping centres may require stroke survivors to ambulate further than a local medical practice (Barclay et al, 2014;Salbach et al, 2014b;Mudge and Monachino, 2013). Similarly, faster gait speeds may be required to cross roads, or navigate crowds at a larger shopping centre than smaller locations such as a medical practice (Salbach et al, 2014b;Andrews et al, 2010).…”

Section: Distancementioning

confidence: 99%

“…For example, larger shopping centres may require stroke survivors to ambulate further than a local medical practice (Barclay et al, 2014;Salbach et al, 2014b;Mudge and Monachino, 2013). Similarly, faster gait speeds may be required to cross roads, or navigate crowds at a larger shopping centre than smaller locations such as a medical practice (Salbach et al, 2014b;Andrews et al, 2010). However, while these challenges may result in increased avoidance of community ambulation early after stroke, the purpose associated with certain community locations, such as essential medical appointments, or grocery shopping, may encourage stroke survivors to continue accessing certain community locations after stroke (Barclay et al, 2014;Ahuja et al, 2013;Barnsley et al, 2012).…”

Section: Distancementioning

confidence: 99%

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Ambulation recovery after stroke

Mahendran¹

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Most stroke survivors regard successful independent ambulation important. However, ambulation recovery is limited following stroke. Historically, limited availability of objective tools and measures to characterise free-living ambulation recovery has restricted investigation of this outcome after survivors return home. However, commercially available devices, including accelerometers and portable global positioning systems, are now available. Thus, this thesis aimed to characterise free-living ambulation recovery over the first six months after stroke survivors returned home from hospital and determine what factors at discharge contributed to ambulation recovery across this time.The first study of this thesis investigated the concurrent validity and retest reliability of accelerometers (ActivPAL TM and Sensewear Pro 2 Armband) and global positioning systems (GPS) (Garmin forerunner 405CX) to measure free-living ambulation after stroke. Measures of step counts, time spent walking, energy expenditure, distance and location were taken during walking tasks that impose demands similar to those encountered when walking in the community as well as free-living community ambulation over four days. This study determined that the ActivPAL TM was valid and reliable for measuring ambulation after stroke. The GPS was valid and reliable for all measures except distance, whereas the Sensewear Pro 2 Armband recorded with high error during all walking tests.The second study aimed to characterise ambulation activity after stroke across the first six months following discharge from hospital and investigate how ambulation activity changed across this time period. Free-living ambulation activity was measured over four days using the ActivPAL TM accelerometer at one, three and six months after stroke survivors left hospital. Measures of volume (daily step counts and time spent walking, sitting/lying, standing and upright), frequency (total number of ambulation bouts; number of bouts and total time spent in short, medium and long duration ambulation bouts) and intensity (number of bouts and total time per day spent in low, moderate and high intensity ambulation bouts) of ambulation activity were collected. This study highlighted that volume of ambulation activity was low across the first six months following hospital discharge, with a majority of ambulation bouts short and low in intensity. Stroke survivors rarely engaged in long duration and high intensity ambulation bouts across the first six months.Daily volume of ambulation activity increased from one month to both three and six months after iv discharge from hospital through an increase in medium duration and moderate intensity ambulation only.The third study aimed to determine what factors at discharge were related to and predicted ambulation activity outcomes over the first six months following hospital discharge in stroke.Factors including age, fatigue, mood, executive function, gait speed, gait endurance, perceived stroke recovery, pre-stroke physical activity, ambulat...

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Section: Walking Capacitymentioning

confidence: 99%

Section: Current Requirements and Criteria For Community Ambulationmentioning

confidence: 99%

Section: Walking Capacitymentioning

confidence: 99%

Section: Distancementioning

confidence: 99%

Section: Distancementioning

confidence: 99%

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Ambulation recovery after stroke

Mahendran¹

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Feasibility of using the NewGait assistive device for correcting gait deviations in individuals with various neurological disorders: Case study

Ustinova,

Langenderfer

2023

Physiotherapy Res Intl

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PurposeImpaired gait is one of the earliest, most devastating, and long‐lasting symptoms associated with neurological disorders. This study tested the feasibility of wearing the NewGait rehabilitative device in individuals with gait impairments due to the most common neurological disorders.MethodsSeven participants with gait impairments due to strokes, Multiple Sclerosis, peripheral neuropathies, Cerebral Palsy (CP) and Parkinson's Disease (PD) were included in the study. Their walking with and without wearing the NewGait was analyzed and compared using the Vicon T160 system for motion analysis. Gait velocity, step length, foot clearance, lateral displacement of the Center of Mass, gait deviation and symmetry indexes were compared using two standard deviation band method for each participant.ResultsParticipants subjectively assessed the NewGait as a comfortable device to wear and showed immediate gait improvements to varying degrees. Most improvements were observed in participants with muscle weakness due to peripheral neuropathies, stroke, MS, and CP. These participants improved their foot clearance, gait velocity, and step length. Participants with cerebellar stroke and PD increased their gait stability. All participants demonstrated a reduction in composite gait deviation indexes. Not all gait parameters, though, showed immediate changes.ConclusionThe results suggest that the NewGait rehabilitative device is feasible and useful for correcting gait impairments caused by neurological deficits. Participants may need to wear this device for longer periods of time in order to achieve long lasting changes in the gait pattern, rather than an immediate correction.

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