Hemiplegic gait after stroke: Is measurement of maximum speed required?

OBJECTIVES: To study the relation between comfortable and maximum walking speed in stroke rehabilitation and to determine which parameters are predictive in this relation and increase the relations' precision.

DESIGN: One-year prospective cohort study. Longitudinal information was obtained for 10-m comfortable and maximum walking speeds, hemiplegic limb muscle strength, and balance. In addition, subjects' ages and the type of rehabilitation they received were registered.

SETTING: Stroke service facilities.

PARTICIPANTS: Eighty-one acute stroke patients.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURE: Ten-meter maximum walking speed.

RESULTS: We found a progressive improvement in walking speed and a mean systematic difference between comfortable and maximum walking speeds. An overall mean intraclass correlation coefficient for consistency of rho equal to .96 and a within- and between-subject regression coefficient of 1.32 were demonstrated for the relation between comfortable and maximum walking speeds. None of the covariables included were statistically significant in the final linear regression prediction model.

CONCLUSIONS: Independent of time after onset of stroke, maximum walking speed can be predicted by comfortable walking speed with considerable accuracy. The precision of this estimation is not increased by considering patients' age, hemiplegic muscle strength, balance, or therapeutic intervention.