Stroke is the leading cause of disability in older adults in the United States, but research by Clarkson University Associate Professor of Physical Therapy George Fulk and his colleagues is pointing the way to recovery for people who are relearning how to walk.
Using data collected over a number of years from two other large clinical trials, the Potsdam, N.Y. researcher and his team were able to create and analyze one large database. Their results show a six-minute walk test is the strongest predictor of walking activity in the home and community for stroke survivors. That information, in turn, helps map the most effective steps for physical rehabilitation and independence.
"One of my main focuses in research and my passion in physical therapy is to better understand how physical therapy interventions help people with stroke to relearn to walk again, so we need to better understand how to measure walking activity," says Fulk. "We can't follow patients around all day, so we measure how they walk in the clinic to try to understand out how they will function in the community and at home. A lot of times clinic and at-home experiences don't match, though."
For example, some people perform better in a clinic because it's a closed safe environment with not as many obstacles to walking. Sometimes, patients could be afraid of falling or they may not have the social support to get out, he notes. Then again, some people may not seem to be as likely to succeed but they just do it.
Step activity monitors turned out to be the answer to the puzzle of how much and how well stroke survivors were walking. Among the factors they measured, researchers found that walking endurance with the six-minute walk test was the strongest individual predictor of community walking activity.
The study matches Fulk's belief that a person's walking endurance, motor function, and balance are essential for walking activity after a stroke, so rehabilitation interventions should focus on these areas to improve a stroke survivor's ability to walk once they leave the hospital or clinic.
"The more we can learn, the more we can help them have a better recovery," Fulk says.
He and his Clarkson University colleague, Assistant Professor of Mathematics Ying He, and Assistant Professor of Rehabilitation Sciences Pierce Boyne and Associate Professor of Rehabilitation Sciences Kari Dunning, both of the University of Cincinnati, published their results online in the journal Stroke on Jan. 5.
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