Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
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A Comparative Study on Clinical Gait Abilities of Stroke Patients According to Indoor and Outdoor Environments

  • Hwang, Hyesun (Department of Physical Therapy, Gangdong Wooridle Convalescent Hospital) ;
  • Woo, Youngkeun (Department of Physical Therapy, College of Medical Sciences, Jeonju University) ;
  • Chung, Yijung (Department of Physical Therapy, College of Health and Welfare, Sahmyook University)
  • Received : 2021.09.09
  • Accepted : 2021.09.21
  • Published : 2021.09.30
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Abstract

Objective: This study aimed to compare gait ability through gait evaluations in indoor and outdoor environments according to the general characteristics and walking ability of stroke patients. Design: Crossed-sectional study. Methods: The subjects of this study were 57 hospitalized stroke patients.The study subjects were asked to select an indoor environment and an outdoor environment in random order, and the Timed Up and Go Test (TUG), 10-Meter Walk Test (10MWT), Figure-Eight Walk Test (F8WT) and the Functional Gait Assessment (FGA) were used to assess each environment. Results: The TUG, 10MWT, F8WT time and number of steps, and FGA showed a significant decrease in gait ability in the outdoor environment compared to the indoor environment (p<0.05). Although the TUG, 10MWT, and the time required for the F8WT were statistically higher in the outdoor compared to the indoor environment at points 2, 3, and 4, but not 5 of the functional ambulatory category (FAC), significant increases in the number of steps of the F8WT were found in the outdoor compared to the indoor environment for only points 2 and 3 of the FAC (p<0.05). In the FAC 3 and 4, there was a statistically significant decrease in the outdoor compared to the indoor environment only in the FGA (p<0.05). Conclusions: Therefore, it has been shown that the gait ability of stroke patients is reduced in the outdoor environment compared to the gait ability in the indoor environment.

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References

  1. An JA, Lee BH. Reliability of joint angle during sit-to-stand movements in persons with stroke using portable gait analysis system based wearable sensors. Phys Ther Rehabil Sci. 2019;8(3):146-151. https://doi.org/10.14474/ptrs.2019.8.3.146
  2. Ahn SN, Hwang S. An investigation of factors influencing the participation of stroke survivors in social and leisure activities. Phys Ther Rehabil Sci. 2018;7(2):67-71. https://doi.org/10.14474/ptrs.2018.7.2.67
  3. Jacobs JM, Cohen A, Hammerman-Rozenberg R, Azoulay D, Maaravi Y, Stessman J. Going outdoors daily predicts long-term functional and health benefits among ambulatory older people. J Aging Health. 2008;20(3):259-272. https://doi.org/10.1177/0898264308315427
  4. de Rooij IJM, van de Port IGL, Visser-Meily JMA, Meijer JWG. Virtual reality gait training versus non-virtual reality gait training for improving participation in subacute stroke survivors: study protocol of the ViRTAS randomized controlled trial. Trials. 2019;20(1):89. https://doi.org/10.1186/s13063-018-3165-7
  5. Kuntapun J, Silsupadol P, Kamnardsiri T, Lugade V. Smartphone monitoring of gait and balance during irregular surface walking and obstacle crossing. Front Sport Act Living. 2020;2:560-577.
  6. Ho S, Mohtadi A, Daud K, Leonards U, Handy TC. Using smartphone accelerometry to assess the relationship between cognitive load and gait dynamics during outdoor walking. Sci Rep. 2019;9(1):3119. https://doi.org/10.1038/s41598-019-39718-w
  7. Praschiv-lonescu A, Newman CJ, Carcreff L, Gerber CN, Armand S, Aminian K. Locomotion and cadence detection using a single trunk-fixed accelerometer: validity for children with cerebral palsy in daily life-like conditions. J Neuroeng Rehabil. 2019;16(1):24. https://doi.org/10.1186/s12984-019-0494-z
  8. Storm FA, Buckley CJ, Mazza C. Gait event detection iin laboratory and real life settings: accuracy of ankle and waist sensor based methods. Gait Posture. 2016;50:42-46. https://doi.org/10.1016/j.gaitpost.2016.08.012
  9. Tamburini P, Storm F, Buckley C, Bisi MC, Stagni R, Mazza C. Moving from laboratory to real life conditions: influence on the assessment of variability and stability of gait. Gait Posture. 2018;59:248-252. https://doi.org/10.1016/j.gaitpost.2017.10.024
  10. Toda H, Maruyama T, Tada M. Indoor vs. outdoor walking: does it make any difference in joint angle depending on road surface? Front Sports Act Living. 2020;2:119. https://doi.org/10.3389/fspor.2020.00119
  11. Holden MK, Gill KM, Magliozzi MR. Gait assessment for neurologically impaired patients. Standards for outcome assessment. Phys Ther. 1986;66(10):1530-1539. https://doi.org/10.1093/ptj/66.10.1530
  12. Mehrholz J, Wagner K, Rutte K, Meissner D, Pohl M. Predictive validity and responsiveness of the funtional ambulation category in hemiparetic patients after stroke. Arch Phys Med Rehabil. 2007;88(10):1314-1319. https://doi.org/10.1016/j.apmr.2007.06.764
  13. Holden MK, Gill KM, Magliozzi MR, Nathan J, Piehl-Baker L. Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. Phys Ther. 1984;64(1):35-40. https://doi.org/10.1093/ptj/64.1.35
  14. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  15. Flansbjer UB, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005;37(2):75-82. https://doi.org/10.1080/16501970410017215
  16. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability fro falls in community-dwelling older adults using the Timed Up & Go test. Phys Ther. 2000;80(9):896-903. https://doi.org/10.1093/ptj/80.9.896
  17. Andersson AG, Kamwendo K, Seiger A, Appelros P. How to identify potential fallers in a stroke unit: validity indexes of 4 test methods. J Rehabil Med. 2006;38(3):186-191. https://doi.org/10.1080/16501970500478023
  18. Watson MJ. Refining the ten-metre walking test for use with neurologically impaired people. Physiother. 2002;88(7):386-397. https://doi.org/10.1016/S0031-9406(05)61264-3
  19. Collen FM, Wade DT, Bradshaw CM. Mobility after stroke: reliability of measures of impairment and disability. Int Disabil Stud. 1990;12(1):6-9. https://doi.org/10.3109/03790799009166594
  20. Schmid A, Duncan PW, Studenski S, Lai SM, Richards L, Subashan P, et al. Improvements in speed-based gait classifications are meaningful. Stroke. 2007;38(7):2096-2100. https://doi.org/10.1161/strokeaha.106.475921
  21. Severinsen K, Jakobsen JK, Overgaard K, Andersen H. Normalized muscle strength, aerobic capacity, and walking performance in chronic stroke: a population-based study on the potential for endurance and resistance training. Arch Phys Med Rehabil. 2011;92(10):1663-1668. https://doi.org/10.1016/j.apmr.2011.04.022
  22. Hess RJ, Brach JS, Piva SR, VanSwearingen JM. Walking skill can be assessed in older adults: validity of the Figure-of-8 Walk test. Phys Ther. 2010;90(1):89-99. https://doi.org/10.2522/ptj.20080121
  23. Wong SST, Yam MS, Ng SSM. The Figure-of-Eight Walk test: reliability and associations with stroke-specific impairments. Disabil Rehabil. 2013;35(22):1896-1902. https://doi.org/10.3109/09638288.2013.766274
  24. Walker ML, 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. https://doi.org/10.2522/ptj.20060344
  25. 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):2021-2025. https://doi.org/10.1161/STROKEAHA.110.589739
  26. Perera S, Mody SH, Woodman RC, Studenski SA. Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr So. 2006;54(5):743-749. https://doi.org/10.1111/j.1532-5415.2006.00701.x
  27. Beninato M, Fernandes A, Plummer LS. Minimal clinically important difference of the Funtional Gait Assessment in older adults. Phys Ther. 2014;94(11):1594-1603. https://doi.org/10.2522/ptj.20130596
  28. Hirota C, Wantanabe M, Sun W, Tanimoto Y, Kono R, Takasaki K, et al. Association between the trail making test and physical performance in elderly Japanese. Geriati Gerontol Int. 2010;10(1):40-47. https://doi.org/10.1111/j.1447-0594.2009.00557.x
  29. Sun W, Watanabe M, Hirota C, Tanimoto Y, Kono R, Takasaki K. Obstacle-negotiating gait and related physical measurement indicators for the community-dwelling elderly in Japan. Arch Gerontol Geriatr. 2010;50(3):e41-e45. https://doi.org/10.1016/j.archger.2009.01.016