Early multidimensional mobility assessments for discriminating discharge-level ambulation and functional independence in subacute stroke inpatients: a retrospective cohort study.
Seung Heun An, Eun Joo Kim, Jun Min Lee
PMID 41988966WHAT IT FOUND
In subacute stroke patients who could walk with supervision, early balance and multidirectional stepping tests best predicted discharge independence.
A Berg Balance Scale score of 40.5 or higher identified 92% of those who achieved independent ambulation, outperforming speed-based gait tests.
Key findings
01Admission Berg Balance Scale and modified Functional Step Test scores showed the strongest correlations with discharge mobility and independence, unlike the 5-Times Sit-to-Stand Test.
02For predicting independent ambulation at discharge, the Berg Balance Scale cut-off of ≥ 40.5 points had 92% sensitivity and 82% accuracy, while the modified Functional Step Test cut-off of ≤ 31.52 seconds had 92% specificity.
03Gait speed and endurance tests (10mWT, 6MWT) had lower classification accuracy (62–70%) for discharge outcomes compared to balance tests, likely because all participants started at a similar walking ability level.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was retrospective and single-centre, limiting generalizability. All participants started at the same walking ability level (supervised walking), which may have made it harder for gait speed tests to show differences. The sample size was small (50 participants), and cut-off values were derived and tested in the same dataset, which can overestimate their accuracy. Time since stroke onset varied from 2 to 5 months, so recovery stages were not uniform.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Ministry of Health and Welfare in South Korea, but the funding institution had no role in the design, analysis, or writing of the paper.
The easy way to misread this
Do not use these cut-off values as definitive diagnostic criteria. They were derived from a small, homogeneous group of patients who could already walk with supervision, and the tests were validated on the same data used to create them, meaning the reported accuracy is likely optimistic.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →