Predictive factors for walking in acute stroke patients: a multicenter study using classification and regression tree analysis.
Kohei Shida, Kazuhiro Fukata, Yuji Fujino and 10 others
PMID 36866009WHAT IT FOUND
At acute stroke discharge, lower limb stage, ability to turn over, and language or inattention predicted independent walking.
Patients with lower limb stage I to III had 0% independent walking in this sample.
Key findings
01In the prediction model, the first split was lower extremity Brunnstrom Recovery Stage. Patients with stage I to III had a 0% probability of independent walking at discharge, and patients with stage IV to VI had a 66.7% probability.
02Among patients with lower extremity stage IV to VI, the ability to turn over from supine separated outcomes. Those with ABMS-T score 1 to 3 had a 10.0% probability of independent walking, and those with score 4 to 6 had a 73.8% probability.
03Among patients with lower extremity stage IV to VI and ABMS-T score 4 to 6, higher brain dysfunction lowered the probability to 52.2%, while its absence gave 82.5%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study did not evaluate walking after discharge, so it says nothing about long-term walking recovery. The prediction model was checked by splitting the same 240 patients into parts, not by a separate independent patient group. The study excluded patients with modified Ranking Scale 3 or higher before admission, subtentorial lesions, bilateral lesions, recurrent stroke, death, no motor paralysis, or missing discharge ambulation score, so it does not cover all acute stroke patients. The authors stated that further studies are needed to confirm the model's usefulness and validity.
Declared interests
This work was supported by the Japan Society for the Promotion of Science (KAKENHI), Grant Number 20K19386. The authors declared no conflicts of interest.
The easy way to misread this
Do not read the 0% probability for lower extremity stage I to III as proof that a patient will never walk independently. It was measured only at discharge, and the study did not follow patients after discharge.