Balance impairment limits ability to increase walking speed in individuals with chronic stroke

Addie Middleton, Carty H. Braun, Michael D. Lewek, Stacy L. Fritz

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose Determine the relationship between balance impairments and the ability to increase walking speed (WS) on demand in individuals with chronic stroke. Methods WS and Berg Balance Scale (BBS) data were collected on 124 individuals with chronic stroke (>6 months). The ability to increase WS on demand (walking speed reserve, WSR) was quantified as the difference between participants’ self-selected (SSWS) and maximal (MWS) walking speeds. Correlation, regression and receiver operating characteristic (ROC) analyses were performed to investigate the relationship between balance and the ability to increase WS. Results Of sample, 58.9% were unable to increase WS on demand (WSR s=0.74, 0.65–0.81) and were predictive of ‘able/unable’ to increase WS [odds ratio (OR) = 0.75, 0.67–0.84]. The AUC for the ROC curve constructed to assess the accuracy of BBS to discriminate between able/unable to increase WS was 0.85 (0.78–0.92). A BBS cutscore of 47 points was identified [sensitivity: 72.6%, specificity: 90.2%, +likelihood ratio (LR): 7.41, −LR: 0.30]. Conclusions The inability to increase WS on demand is common in individuals with chronic stroke, and balance appears to be a significant contributor to this difficulty. A BBS cutscore of 47 points can identify individuals who may benefit from balance interventions to improve the ability to increase their WS.Implications for RehabilitationA majority of individuals with chronic stroke may be unable to increase their walking speed beyond their self-selected speed on demand.This may limit functional ambulation, as these individuals are walking “at capacity”.Balance impairments contribute to the inability to increase walking speed.A Berg Balance Scale score

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalDisability and Rehabilitation
DOIs
StateAccepted/In press - Mar 7 2016

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Stroke
ROC Curve
Walking Speed
Walking
Area Under Curve
Odds Ratio
Sensitivity and Specificity

Keywords

  • Ambulation
  • balance
  • cerebrovascular accident
  • difficulty walking
  • gait
  • outcome measures
  • postural

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Balance impairment limits ability to increase walking speed in individuals with chronic stroke. / Middleton, Addie; Braun, Carty H.; Lewek, Michael D.; Fritz, Stacy L.

In: Disability and Rehabilitation, 07.03.2016, p. 1-6.

Research output: Contribution to journalArticle

Middleton, Addie ; Braun, Carty H. ; Lewek, Michael D. ; Fritz, Stacy L. / Balance impairment limits ability to increase walking speed in individuals with chronic stroke. In: Disability and Rehabilitation. 2016 ; pp. 1-6.
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abstract = "Purpose Determine the relationship between balance impairments and the ability to increase walking speed (WS) on demand in individuals with chronic stroke. Methods WS and Berg Balance Scale (BBS) data were collected on 124 individuals with chronic stroke (>6 months). The ability to increase WS on demand (walking speed reserve, WSR) was quantified as the difference between participants’ self-selected (SSWS) and maximal (MWS) walking speeds. Correlation, regression and receiver operating characteristic (ROC) analyses were performed to investigate the relationship between balance and the ability to increase WS. Results Of sample, 58.9{\%} were unable to increase WS on demand (WSR s=0.74, 0.65–0.81) and were predictive of ‘able/unable’ to increase WS [odds ratio (OR) = 0.75, 0.67–0.84]. The AUC for the ROC curve constructed to assess the accuracy of BBS to discriminate between able/unable to increase WS was 0.85 (0.78–0.92). A BBS cutscore of 47 points was identified [sensitivity: 72.6{\%}, specificity: 90.2{\%}, +likelihood ratio (LR): 7.41, −LR: 0.30]. Conclusions The inability to increase WS on demand is common in individuals with chronic stroke, and balance appears to be a significant contributor to this difficulty. A BBS cutscore of 47 points can identify individuals who may benefit from balance interventions to improve the ability to increase their WS.Implications for RehabilitationA majority of individuals with chronic stroke may be unable to increase their walking speed beyond their self-selected speed on demand.This may limit functional ambulation, as these individuals are walking “at capacity”.Balance impairments contribute to the inability to increase walking speed.A Berg Balance Scale score",
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AB - Purpose Determine the relationship between balance impairments and the ability to increase walking speed (WS) on demand in individuals with chronic stroke. Methods WS and Berg Balance Scale (BBS) data were collected on 124 individuals with chronic stroke (>6 months). The ability to increase WS on demand (walking speed reserve, WSR) was quantified as the difference between participants’ self-selected (SSWS) and maximal (MWS) walking speeds. Correlation, regression and receiver operating characteristic (ROC) analyses were performed to investigate the relationship between balance and the ability to increase WS. Results Of sample, 58.9% were unable to increase WS on demand (WSR s=0.74, 0.65–0.81) and were predictive of ‘able/unable’ to increase WS [odds ratio (OR) = 0.75, 0.67–0.84]. The AUC for the ROC curve constructed to assess the accuracy of BBS to discriminate between able/unable to increase WS was 0.85 (0.78–0.92). A BBS cutscore of 47 points was identified [sensitivity: 72.6%, specificity: 90.2%, +likelihood ratio (LR): 7.41, −LR: 0.30]. Conclusions The inability to increase WS on demand is common in individuals with chronic stroke, and balance appears to be a significant contributor to this difficulty. A BBS cutscore of 47 points can identify individuals who may benefit from balance interventions to improve the ability to increase their WS.Implications for RehabilitationA majority of individuals with chronic stroke may be unable to increase their walking speed beyond their self-selected speed on demand.This may limit functional ambulation, as these individuals are walking “at capacity”.Balance impairments contribute to the inability to increase walking speed.A Berg Balance Scale score

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