Walking speed at the acute and subacute stroke stage: A descriptive meta-analysis

Abstract

Gait disorders are one of the leading patient complaints at the sub-acute stroke stage (SSS) and a main determinant of disability. Walking speed (WS) is a major vital and functional index, and the Ten-Meter Walk Test is considered the gold standard after stroke. Based on a systematic review of the literature, studies published between January 2000 and November 2021 were selected when WS was reported (ten-meter walk test for short distance and/or 6-min walking distance for long distance) within 6 months following a first ischemic and/or hemorrhagic stroke (SSS) in adults prior to receiving specific walking rehabilitation. Following PRISMA guidelines, a meta-analysis was conducted on two kinds of WS: the principal criterion focused on short-distance WS (ten-meter walking test) and the secondary criteria focused on long-distance WS (6-min test) and meta-regressions to study the association of WS with balance, cognitive disorders and autonomy. Nine studies comprising a total of 939 data on post-stroke patients were selected. The weighted average age was 61 years [95% IC [55-67] and males represented 62% ± 2.7 of patients [57-67]. Average short-distance WS was 0.36 ± 0.06 m.s−1 [95% CI (0.23–0.49)]. Average long-distance WS was 0.46 ± 0.1 m.s−1 [95% CI (0.26–0.66)]. The funnel plot revealed asymmetry of publication bias and high heterogeneity of the nine studies (I2 index 98.7% and Q-test p < 0.0001). Meta-regressions of secondary endpoints could not be performed due to a lack of study data. At the SSS, WS would be lower than data in general population published in literature, but above all, lower than the WS required for safe daily autonomy and community ambulation after stroke. WS must be a priority objective of stroke rehabilitation to increase walking function but also for survival, autonomy, social participation and health-related quality of life.

Gait Analysis in Neurorehabilitation: From Research to Clinical Practice

“…In PD patients, walking impairments such as freezing of gait occur in 39.9%, especially in those with 10 years of the disease and with a H&Y score >2.5 [54]. Similarly, acquired brain injury patients have gait impairments in 80% of cases due to loss of postural control, cognitive alterations, and executive dysfunctions [47,55]. Traditionally, spatial-temporal parameters of gait, such as velocity, stride length, and step time, are the most quantified ones during the analysis of gait.…”

Dual-task versus single-task gait rehabilitation after stroke: the protocol of the cognitive-motor synergy multicenter, randomized, controlled superiority trial (SYNCOMOT)

“…Gait speed is the "gold standard" measure of gait performance [64]. At the subacute stage of stroke, speed was recently estimated to be 0.34 m.s −1 , i.e., a 70% decrease [53]. The ST 10MWT will be used to assess gait performance in the DT GR and ST GR groups at post-stroke M6.…”

“…This test is a key indicator of functional gait performance, the risk of falls, and decline after stroke [40,41]; it constitutes the gold standard for the provision of quantitative data on gait performance. Performance in the 10MWT is known to be related to community ambulation ability and QoL [10,53,[63][64][65][66].…”

“…The treating therapist will be notified by the DRCI (by e-mail) of the treatment allocation. The study database The motor part of the Fugl-Meyer Assessment of the lower extremity [47] d Assessment of neuropsychological cognitive abilities, using the French adaptation [29] of the Harmonization Standards protocol [48]; assessment of behavioral dysexecutive disorders, using the previously validated Behavioral Dysexecutive Syndrome Inventory) [49] NIHSS National Institutes of Health Stroke Scale, FIM the Functional Independence Measure [50], mRS-SI a structured interview with a modified Rankin score [51], QoL-VAS visual analog scale for quality of life, AE adverse event, SAE serious adverse event, ST 10MWT single-task 10-meter walk test [52,53], DT 10MWT dual-task 10-m walk test, with four cognitive tasks during gait, the verbal Trail-Making Test (executive function), a symbol praxis task, a literal fluency task, and a verbal serial recall task (short-term memory), ST TUG single-task timed up-and-go test, DT TUG dual-task timed up-and-go test, with four cognitive tasks during gait, the verbal Trail-Making Test (executive function), a symbol praxis task, a literal fluency task, and a verbal serial recall task (short-term memory), MRI magnetic resonance imagery, fMRI functional MRI, fMRS functional magnetic resonance spectroscopy…”

Beyond gait speed: exploring the added value of Inertial Measurement Unit-based measurements of gait in the estimation of the walking ability in daily life

“…to ambulate independently inside and outside their home [ 1 – 3 ]. During rehabilitation, this ability is often estimated with a measurement of gait speed, for instance a two-minute walk test (2MWT) [ 4 – 8 ]. Evidence suggests there is a strong association between gait speed and the walking ability; a higher gait speed is linked to increased community ambulation [ 4 – 6 ].…”