Factors Associated with the Walking Ability of Hemiplegic Stroke Patients

Hemiplegic stroke patients often experience gait disturbance, such as spastic gait, due to motor paralysis. Gait disturbance affects activities of daily living (ADL) and the quality of life of patients. Thus, early walking training is essential. This study aimed to clarify the factors affecting the walking ability of hemiplegic stroke patients.

Eighty hospitalized patients with a first chemic or hemorrhagic stroke within 1 year but not less than 1 month after stroke onset were included in this study. The dependent variable was walking ability (Functional Independence Measure [FIM] locomotion score), and the independent variables were spirituality(Spirituality Rating Scale-A [SRS-A]), amount of social support (Japanese version of the Abbreviated Multidimensional Scale of Perceived Social Support, frequency of family visit), stroke severity (National Institutes of Health Stroke Scale [NIHSS]), degree of motor paralysis (lower extremity Brunnstrom stage), the lower limb loading force of the affected and unaffected side, and age. Spearman’s rank correlation coefficient and multiple regression analysis were performed. 

Multiple regression analysis showed that FIM locomotion score was associated with NIHSS (standard partial regression coefficient= −0.362, P < 0.001), the unaffected lower limb loading force (standard partial regression coefficient =0.264, P < 0.001), lower extremity Brunnstrom stage (standard partial regression coefficient = 0.352, P < 0.001), and SRS-A (standard partial regression coefficient = 0.184, P < 0.011). 

In conclusion, the walking ability of hemiplegic stroke patients was affected by stroke severity and the degree of paralysis, the unaffected lower limb loading force, and the spirituality level in patients with stroke. Promoting walking ability in patients with stroke includes training the unaffected lower limb and heightening spirituality. Training of the unaffected lower limb should be performed at the bedside or on the bed by the patient or a bedside nurse. To heighten spirituality, nurses who care for patients with stroke are encouraged to practice active listening and to show sympathy as part of emotional support and spiritual care.

Article by Akira Matsuyama, from Toyohashi Sozo University, Aichi, Japan.

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Image by Koen Verlinden, from Flickr-cc.