The relation between gait velocity and static and dynamic balance in the early rehabilitation of patients with acute stroke

The main purpose of this study was to investigate relationships between gait velocity, static and dynamic balance in patients with first time ever stroke in the acute rehabilitation period. Patients with first ever stroke (n=57) were consecutively included during 2003–04. Mean age was 74 years (range 38–98) and mean time at the stroke unit was 18 days (range 5–47). The 6-minute walk test (6MWT) was the main outcome measure in addition Motor Assessment Scale (MAS) items 3 and 5, Berg's Balance Scale (BBS) items 6 and 8 and Timed Up-and-Go (TUG) was measured on admission to and at discharge from the stroke unit. 6MWT correlated highly to balance measures MAS items 3 and 5, BBS items 6 and 8 and the TUG (rs between 0.53 and 0.82) on admission and at discharge (rs between 0.47 – 0.67). Stepwise regression analysis on admission showed the TUG (p<0.001), MAS item 3 (p<0.01) and BBS item 8 (p<0.03) to be explanatory factors for gait velocity, with an adjusted R2 0.83. At discharge, the TUG (p<0.02), MAS item 3 (p<0.001) and BBS item 8 (p<0.001), with an adjusted R2 of 0.73, were the main explanatory factors for gait velocity. The strong relationships between 6MWT and static balance, measures (MAS item 3 (sitting) and BBS item 6 (standing blindfolded), on admission indicate enhancement of stability at this early stage in stroke patients. The relationships between gait velocity and dynamic balance, MAS item 5 (walking), BBS item 8 (reaching), indicate that dynamic balance, also, is related to gait velocity at this stage. The clinical implication being that balance, both static and dynamic needs to be addressed equally in the early rehabilitation of stroke patients, and is closely related to task, e.g. walking, getting up from a chair, turning and reaching, and cannot be regarded as separate from the task.