Background: Impaired walking contributes to functional disability post-stroke. Poor walking recovery has been associated with greater stroke severity, and it is assumed that there is little functional recovery after 6-months post-stroke.
Aims: To describe walking function and recovery in a cohort of moderate/severely affected stroke survivors who received inpatient rehabilitation, and explore the association between cognition, mood, and walking recovery.
Methods: In this study, we used an existing data set drawn from a cohort of consecutive inpatients receiving rehabilitation at a specialised acquired brain injury ward (2015-17). We only included data from patients with ischaemic/hemorrhagic and excluded traumatic brain injury. All participants were assessed at admission to and discharge from inpatient rehabilitation and again at 12, 24, and 36 months post-stroke. Walking recovery was clinically evaluated on the Functional Independence Measure (FIM™).
Results: 44 moderate/severe stroke survivors were included (hemorrhage n=30, ischaemic n=14), median age 51y (17-78), 25 males (57%) median 49 days post-stroke (range 9-333). Number of participants varied over time (at 12 months, n=34; 24 months, n=29; 36 months, n=20). Based on the FIM walking score 72% had complete walking dependence, 16% had modified dependence, and 12% were able to independently walk at admission. At discharge, 62% improved on walking dependence, from discharge-12 months 21% improved, 14% between 12-24, and 18% between 24-36 months. Further analyses include exploring associations between mood, cognition, and walking recovery and will be included in the presentation if successful.
Conclusion: Walking ability did improve in this cohort of patients with moderate/severe stroke receiving rehabilitation. People who were lost to follow-up might have had more severe strokes and therefore the proportion of recovery might be smaller. Detailed knowledge of mobility recovery and the time course of recovery is limited in the severe stroke population, yet may prove invaluable for planning future rehabilitation.