Assessment of conformity and repeatability of chosen scales used for evaluation of gait after brain stroke

Authors

Keywords:

stroke, gait disorders, evaluation of disability

Abstract

Introduction: Locomotor disorders at a patient after stroke significantly deteriorate his/her everyday functioning and quality of life. Improvement of gait pattern is often a crucial task in post-stroke neurorehabilitation as the ability to move unaided allows the patient to achieve the highest possible level of independence and actively participate in social life. Various measuring tools are used to evaluate the locomotor functions.

Purpose: The aim of this paper was to assess the conformity and accuracy of chosen tools (i.e. Functional Gait Assessment, Dynamic Gait Index and Wisconsin Gait Scale) enabling the evaluation of gait functions of stroke survivors.

Material and methods: The study included 30 patients with hemiparesis who had undergone a stroke once at least six months before the research. The gait function of each patient was assessed in the ten-point Functional Gait Assessment (FGA) scale, the Dynamic Gait Index (DGI) scale, the Wisconsin Gait Scale (WGS) and 10-meter walk test. Balance, however, was evaluated using the Berg Balance Scale and Get Up and Go test.

Results: The test making use of FGA proved a high level of repeatability (p=0,64) as well as high internal (α=0,86) and external (r=0,96) consistency of the achieved results. The study found out significant correlation between the gait assessments conducted according to DGI and FGA scale (r= 0,95) and strong dependency between values of FGA and WGS (r= - 0,75). All correlations were statistically significant.

Conclusion: FGA, DGI and WGS scales are characterised by high internal and external conformity of results. They are good and recommended clinical tests used for assessment of gait of post-stroke patients with paresis.

Downloads

Download data is not yet available.

References

De Laat K, Van Norden A, Gons R , van Oudheusden L, van Uden I, Bloem B et al. Gait in elderly with cerebral small vessel disease. Stroke 2010; 41; 8; 1652-1658.

Ng M, Tong R, Li L. A pilot study of randomized clinical controlled trial of gait training in subacute stroke patients with partial body-weight support electromechanical gait trainer and functional electrical stimulation six-month follow-up. Stroke 2008; 39; 1; 154-160.

Visintin M, Barbeau H, Korner-Bitensky N, Mayo N. A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke 1998; 29; 6; 1122-1128.

Goldie PA, Matyas TA, Evans OM. Gait after stroke: initial deficit and changes in temporal patterns for each gait phase. Arch Phys Med Rehabil 2001; 82; 8; 1057-1065.

Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil 2003; 84; 8; 1185-1193.

Kwolek A, Lewicka K. Analiza przyczyn upadków chorych z niedowładem połowiczym, rehabilitowanych szpitalnie. Ortop Traumatol Rehab 2002; 5; 5; 606-612.

Paolucci S, Bragoni M, Coiro P, De Angelis D, Fusco FR, Morelli D et al. Quantification of the probability of reaching mobility independence at discharge from a rehabilitation hospital in nonwalking early ischemic stroke patients: a multivariate study. Clin Rehabil 2008; 26; 1; 16-26.

Teasell RW, Bhogal SK, Foley NC, Speechley MR. Gait retraining post stroke, Top Stroke Rehabil 2003; 10; 2; 34-65.

Jackson D, Thornton H, Turner-Stokes L. Can young severely disabled stroke patients regain the ability to walk independently more than three months post stroke? Clin Rehabil 2000; 14; 5; 538–547.

Kollen B, Kwakkel G, Lindeman E. Longitudinal robustness of variables predicting independent gait following severe middle cerebral artery stroke: a prospective cohort study. Clin Rehabil 2006; 20; 3; 262–268.

Mulroy SJ, Klassen T, Gronley JK, Eberly VJ, Brown DA, Sullivan KJ. Gait parameters associated with responsiveness to treadmill training with body-weight support after stroke: an exploratory study. Phys Ther 2010; 90; 2; 209-223.

Alexander L, Black S, Patterson K, Gao F, Danells C, McIlroy W. Association between gait asymmetry and brain lesion location in stroke patients. Stroke 2009; 40; 2; 537-544.

Demain S, Wiles R, Roberts L, McPherson K. Recovery plateau following stroke: fact or fiction? Disabil Rehabil 2006; 28; 13-14; 815-821.

Van Peppen RP, Kwakkel G, Wood-Dauphinee S, Hendriks HJ, Van der Wees P.J, Dekker J. The impact of physical therapy on functional outcomes after stroke: What’s the evidence? Clin Rehabil 2004; 18; 8; 833–862.

Nilsson L, Carlsson J, Danielsson A, Fugl-Meyer A, Hellstrom K, Kristensen L et al. Walking training of patients with hemiparesis at an early stage after stroke: A comparison of walking training on a treadmill with body weight support and walking training on the ground. Clin Rehabil 2001; 15; 5; 515-527.

Classen J, Liepert J, Wise SP, Hallett M, Cohen LG . Rapid plasticity of human cortical movement representation induced by practice. J Neurophysiol 1998; 79; 2; 1117–1123.

Liepert J, Bauder H, Wolfgang HR, Miltner WH, Taub E, Weiller C. Treatment-induced cortical reorganization after stroke in humans. Stroke 2000; 31; 6; 1210–1216.

Luft AR, Forrester L, Macko RF, McCombe-Waller S, Whitall J, Villagra F et al. Brain activation of lower extremity movement in chronically impaired stroke survivors. Neuroimage 2005; 26; 1; 184-194.

Drużbicki M, Pacześniak-Jost A, Kwolek A. Metody klinometryczne stosowane w rehabilitacji neurologicznej. Prz Med. Uniw Rzesz Inst Leków 2007; 5; 3; 268-274.

Shumway-Cook A, Woollacott MH. Motor control: theory and practical applications. 2006. 3rd ed. Baltimore Lippincott Williams & Wilkins.

Wrisley DM, Marchetti GF, Kuharsky DK, Whitney SL. Reliability, internal consistency, and validity of data obtained with the Functional Gait Assessment. Phys Ther 2004; 84; 10; 906-918.

Walker M, Austin AG, Banke GM, Foxx SR, Gaetano L, Gardner LA et al. Reference Group Data for the Functional Gait Assessment. Phys Ther 2007; 87; 11; 1468-1477.

Rodriquez AA, Black PO, Kile K.A, Sherman J, Stellberg B, McCormnick J et al. Gait training efficacy using a home-based practice model in chronic hemiplegia. Arch Phys Med Rehabil 1996; 77; 7 801–805.

Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992; 83; 2; 7-11.

Quinn TJ, Dawson J, Walters MR, Lees KR. Functional outcome measures in contemporary stroke trials. Int J Stroke 2009; 4; 3; 200-205.

Quinn TJ, Langhorne P, Stott DJ. Barthel Index for stroke trials: Development, Properties, and Application. Stroke 2011; 42; 4; 1146-1151.

Lim KB, Kim JA. Activity of Daily Living and Motor Evoked Potentials in the subacute stroke patients. Ann Rehabil Med 2013; 37; 1; 82-87.

Hill KD, Goldie PA, Baker PA, Greenwood KM. Retest reliability of the temporal and distance characteristics of hemiplegic gait using a footswitch system. Arch Phys Med Rehabil 1994; 75; 5; 577-83.

Roos MA, Rudolph KS, Reisman DS (2012). The structure of walking activity in people after stroke compared with older adults without disability: a cross-sectional study. Phys Ther 2012; 92; 2; 1141–1147.

Hong SJ, Goh EY, Chua SY, Ng SS. Reliability and validity of step test scores in subjects with chronic stroke. Arch Phys Med Rehabil 2012; 96; 2; 1065-71.

Harrison JK, McArthur KS, Quinn TJ. Assessment scales in stroke: clinimetric and clinical considerations. Clin Interv Aging 2013; 8; 201-211.

Lees R, Fearon P, Harrison JK, Broomfield NM, Quinn TJ . Cognitive and mood assessment in stroke research: focused review of contemporary studies. Stroke 2012; 43; 6; 1678-1680.

Lin JH, Hsu MJ, Hsu HW, Wu HC, Hsieh CL. Psychometric comparisons of 3 functional ambulation measures for patients with stroke. Stroke 2010; 41; 9; 2021-5.

Steffen TM, Hacker TA, Mollinger L. Age and gender – related test performance in community-dwelling eldery elderly people: Six- minute walk test, Berg Balance Scale, Timed Up&Go Test and Gait Speeds. Phys Ther 2002; 82; 2; 128-137.

Flansbjer B, Holmbäck A.M, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and woman with hemiparesis after stroke. J Rehabil Med 2005; 37; 2; 75-82.

Turani N, Kemiksizog A, Karatas M. Assessment of hemiplegic gait using the Wisconsin Gait Scale”, Scandinavian Journal of Caring Sciences 2004; 18; 1; 103-108.

Drużbicki M, Szymczyk D, Snela S, Dudek J, Chuchla M. Obiektywne, ilościowe metody analizy chodu w praktyce klinicznej. Prz Med. Uniw Rzesz Inst Leków 2009; 9; 4; 356-362.

Campanini I, Merlo A. Reliabilty Rebiability, smallest real difference and concurrent validity of indices computed from GRF components in gait of stroke patients. Gait Posture 2009; 30; 2; 127-131.

Thieme H, Ritschel C, Zange C. Reliability and validity of the functional gait assessment (German version) in subacute stroke patients. Arch Phys Med Rehabil 2009; 90; 9; 1565-70.

Tuomela J, Paltamaa J, Hakkinen A. Reliability of the Dynamic Gait Index (Finnish version) in individuals with neurological disorders. Disabil Rehabil 2012; 34; 19; 1657-64.

Jonsdottir J, Cattaneo D. Reliability and validity of the Dynamic Gait Index in persons with chronic stroke. Arch Phys Med Rehabil 2007; 88; 11; 1410-1415.

Pizzi A, Carlucci G, Falsini C, Lunghi F, Verdesca S, Grippo A. Gait in hemiplegia: evaluation of clinical features with the Wisconsin Gait Scale. J Rehabil Med 2007; 39; 2; 170-174.

Downloads

Published

2014-12-30

How to Cite

Podgórska-Bednarz, J., Wyszyńska, J., Drużbicki, M., Przysada, G., Czenczek-Lewandowska, E., Leszczak, J., & Baran, J. (2014). Assessment of conformity and repeatability of chosen scales used for evaluation of gait after brain stroke. European Journal of Clinical and Experimental Medicine, 12(4), 326–333. Retrieved from https://journals.ur.edu.pl/ejcem/article/view/12538