Prediction of independent ambulation in subacute stroke patients: a retrospective observational study using lower limb motor and balance assessments
Jungwoo Shim
Abstract
OBJECTIVE: To investigate whether motor and balance assessments predict independent ambulation in patients with subacute stroke. DESIGN: Retrospective observational study. SUBJECTS/PATIENTS: 109 patients admitted for inpatient rehabilitation within 3 months of stroke onset. METHODS: Independent ambulation was defined as a Functional Ambulation Category score of 4 or higher on discharge. The Fugl-Meyer Assessment for Lower Limb and Berg Balance Scale were administered on admission. Associations with walking independence on both admission and discharge were examined using binary logistic regression, adjusted for age, sex, and Korean Mini-Mental State Examination scores. Discriminative ability was assessed using receiver operating characteristic curve analysis. RESULTS: On admission, both the Fugl-Meyer -Assess-ment for Lower Limb (B = 0.42, p < 0.001, odds ratio = 1.52) and the Berg Balance Scale (B = 0.31, p < 0.001, odds ratio = 1.37) were significantly -associated with walking independence. Both assessments also significantly predicted independence in ambulation on discharge. The Berg Balance Scale showed excellent discriminative performance (area under the curve = 0.97 on admission, 0.88 on discharge), and the Fugl-Meyer Assessment also performed well (area under the curve = 0.89 and 0.82). CONCLUSION: Admission motor and balance assessments are significant predictors of walking independence in subacute stroke patients and may inform early rehabilitation decisions.