Utility of Community-Based Gait Speed Outcome Measures and Cut-Offs for Stroke

PURPOSE: Chronic stroke is associated with declines in gait speed (GS) associated with loss of participation, endurance, and increased institutionalization. GS categories described by Perry and Fulk can designate gait function and set goals for rehabilitation. It is unknown which GS tests and associated functional categories have better utility for goal setting in a group of community-dwelling patients with chronic stroke. METHODS: An observational cohort design. A community-based clinic affiliated with a Doctor of Physical Therapy program. Included 21 patients with severe stroke. Patients received 10 weekly 1-hour pro-bono physical therapy sessions. GS was measured by the 10-meter walk test (10MWT) and 6-minute walk test (6MWT). RESULTS: Gains were found in the 6MWT (p=0.023) but not the 10MWT (p=0.569); however, minimum clinically important difference was not attained for either test. At discharge, fewer participants achieved the faster Fulk cut-offs than Perry cut-offs. DISCUSSION: Treatment was associated with improved GS using the 6MWT but not the 10MWT. Treatment impact was likely attenuated due to the limited dose of intervention. Applying functional GS categories as described by Fulk to people with severe stroke living in the community has more utility for program planning since achieving faster GS could prevent undesirable functional declines.