Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26084
Title: Factors associated with time to independent walking recovery post-stroke.
Austin Authors: Kennedy, Caitlin;Bernhardt, Julie;Churilov, Leonid ;Collier, Janice M;Ellery, Fiona;Rethnam, Venesha;Carvalho, Lilian B;Donnan, Geoffrey A ;Hayward, Kathryn S 
Affiliation: Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
Melbourne Brain Centre, The Royal Melbourne Hospital, Parkville, Victoria, Australia
The University of Melbourne, Parkville, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health
NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Melbourne, Victoria, Australia
Issue Date: 2021
metadata.dc.date: 2021-03-17
Publication information: Journal of neurology, neurosurgery, and psychiatry 2021; 92(7): 702-708
Abstract: Past studies have inconsistently identified factors associated with independent walking post-stroke. We investigated the relationship between pre-stroke factors and factors collected acutely after stroke and number of days to walking 50 m unassisted using data from A Very Early Rehabilitation Trial (AVERT). The outcome was recovery of 50 m independent walking, tested from 24 hours to 3 months post-stroke. A set of a priori defined factors (participant demographics: age, sex, handedness; pre-stroke: hypertension, ischaemic heart disease, hypercholesterolaemia, diabetes mellitus, atrial fibrillation; stroke-related: stroke severity, stroke type, ischaemic stroke location, stroke hemisphere, thrombolysis) were investigated for association with independent walking using a cause-specific competing risk Cox proportional hazards model. Respective effect sizes are reported as cause-specific adjusted HR (caHR) adjusted for age, stroke severity and AVERT intervention. A total of 2100 participants (median age 73 years, National Institutes of Health Stroke Scale 7, <1% missing data) with stroke were included. The median time to walking 50 m unassisted was 6 days (IQR 2-63) and 75% achieved independent walking by 3 months. Adjusted Cox regression indicated that slower return to independent walking was associated with older age (caHR 0.651, 95% CI 0.569 to 0.746), diabetes (caHR 0.836, 95% CI 0.740 to 0.945), severe stroke (caHR 0.094, 95% CI 0.072 to 0.122), haemorrhagic stroke (caHR 0.790, 95% CI 0.675 to 0.925) and right hemisphere stroke (caHR 0.796, 95% CI 0.714 to 0.887). Our analysis provides robust evidence for important factors associated with independent walking recovery. These findings highlight the need for tailored mobilisation programmes that target subgroups, in particular people with haemorrhagic and severe stroke.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26084
DOI: 10.1136/jnnp-2020-325125
ORCID: 0000-0002-3344-4674
0000-0002-2787-8484
0000-0002-9807-6606
0000-0003-2950-4870
0000-0002-7302-1895
0000-0002-0493-8536
0000-0002-9803-7631
0000-0001-6324-3403
0000-0001-5240-3264
PubMed URL: 33737383
Type: Journal Article
Subjects: acute
independent
rehabilitation
Stroke
walking
Appears in Collections:Journal articles

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