Gait disorders in subacute stroke: Meta-analysis and case series - 15/07/18
Résumé |
Introduction/Background |
Gait disorders are one of the first complaints after a stroke. No specific classification of these gait disorders has been proposed in the literature. Furthermore, few epidemiological data are available, including speed and walking abilities in acute and subacute stages.
Objectives |
To determine the walking speed and prevalence of acute and subacute gait disorders after stroke. To propose a classification of gait disorders, and analyze the link between motor and cognitive impairments, walking abilities and patient outcomes.
Material and method |
A meta-analysis was performed, selecting hospital based-studies reporting walking speed after a first stroke. Then, we evaluated the walking abilities of patients in a neurovascular unit. The severity of the stroke was evaluated using the National Institute of Health Stroke Scale (NIHSS), cognitive functions with the Mini-Mental State Examination (MMSE), autonomy using Modified Rankin Scale (Rkm), and gait autonomy with the Functional Ambulation Categories (FAC). In addition, a classification of gait disorders was established for the study.
Results |
Prevalence of gait disorders in acute and subacute stroke was 63.6%, with an average walking speed of 0.34m/s. Walking abilities depends on initial stroke severity, location of ischemic stroke, and patient's outcome (P=0001). Walking speed was associated with cognitive functions (P=0.01), as well as walking abilities (P=0.001).
Conclusion |
Gait disorders are frequent in acute and subacute post-stroke stages, with a decrease in walking speed>70%. Walking abilities depends on the initial severity of the stroke, and are predictive of patients’ outcome. In addition, walking and cognitive functions seem to be linked after stroke, demonstrating cognitive-motor interference. Eventually, the classification proposed in this study will allow a better management of post-stroke gait disorders and rehabilitation.
Le texte complet de cet article est disponible en PDF.Keywords : Stroke, Neurologic gait disorders, Walking speed
Plan
Vol 61 - N° S
P. e200 - juillet 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.