Objectives

This study aims to 1) identify the relation between walking ability and participation after stroke and 2) explore whether change in walking ability is associated with change in participation over time in community living-people after stroke.

Materials and Methods

Fifty-two people after stroke were assessed at baseline and after a 6-week gait training intervention. People were included between two weeks and six months after stroke. The Utrecht Scale for Evaluation of Rehabilitation-Participation was used to measure participation. Assessment of walking ability included the six-minute walking test for walking endurance, Timed-up & Go test for functional mobility, Mini Balance Evaluation Systems Test for dynamic balance, and total duration of walking activity per day to measure walking activity.

Results

At baseline, six-minute walking test, Timed-up & Go test, and Mini Balance Evaluation Systems Test were univariately associated with participation (P < 0.001). Backward multiple regression analysis showed that the Mini Balance Evaluation Systems Test independently explained 55.7% of the variance in participation at baseline. Over time, only change in the six-minute walking test was positively associated with change in participation (R² = 0.087, P = 0.040).

Conclusions

Cross-sectional associations showed that walking ability, and especially dynamic balance, contributes to participation after stroke. Dynamic balance, as underlying variable for walking, was an important independently related factor to participation after stroke which needs attention during rehabilitation. Longitudinally, improvement in walking endurance was significantly associated with improvement in participation, which indicates the relevance of training walking endurance to improve participation after stroke.

中文翻译：

---

步行能力在多大程度上与中风后人们的参与有关？

目标

本研究旨在 1) 确定中风后步行能力与参与度之间的关系，以及 2) 探讨步行能力的变化是否与中风后社区居民的参与度随时间的变化有关。

材料和方法

中风后的 52 人在基线和 6 周的步态训练干预后进行了评估。人们在中风后两周到六个月之间被纳入研究。乌得勒支康复参与评估量表用于衡量参与。步行能力的评估包括步行耐力的 6 分钟步行测试、功能移动性的 Timed-up & Go 测试、动态平衡的迷你平衡评估系统测试以及每天步行活动的总持续时间以测量步行活动。

结果

在基线时，六分钟步行测试、Timed-up & Go 测试和迷你平衡评估系统测试与参与度单变量相关（P < 0.001）。后向多元回归分析表明，迷你平衡评估系统测试独立解释了基线参与方差的 55.7%。随着时间的推移，只有六分钟步行测试的变化与参与的变化呈正相关（R ² = 0.087，P = 0.040）。

结论

横断面关联表明，步行能力，尤其是动态平衡，有助于中风后的参与。动态平衡作为步行的潜在变量，是中风后参与的重要独立相关因素，在康复过程中需要注意。从纵向来看，步行耐力的提高与参与度的提高显着相关，这表明训练步行耐力与提高中风后的参与度有关。