아급성기 뇌졸중 환자의 보행속도가 지역사회 보행에 미치는 예측과 판별타당도 = Predictive and discriminative validity of walking speed for community ambulation in subacute stroke patients

다국어 초록 (Multilingual Abstract)

Background: This study was to determine the cut-off values of pre- and post-training walking speeds in subacute stroke patients that could predict community ambulation four weeks after training, and to assess their predictive and discriminative validity.
Design: Retrospective(cross-sectional) study Methods: Data were collected from 39 stroke patients(FAC 3 points), evaluating functional ambulation category (FAC), 10-meter walk test(10mWT), 6-Minute walk test(6MWT), and Berg balance scale(BBS) before and four weeks after training. The study analyzed whether pre- and post-training 10mWT speeds could predict the total distance covered in the 6MWT after training.
Results: The pre- and post-training 10mWT speeds were significant predictors of total distance in the 6MWT, explaining 83% and 90% of the variance, respectively. The cut-off values and AUC for predicting or distinguishing community ambulation (>288m) using the 10mWT were >0.43 m/s (0.879, p<.014) before training and >0.65 m/s (0.964, p<.003) after training. The pre-training cut-off value of 0.43 m/s had a sensitivity of 75%, specificity of 68%, positive predictive value of 21%, negative predictive value of 96%, and overall accuracy of 69% in predicting community ambulation. Patients with a pre-training 10mWT speed >0.43 m/s were 6.5 times more likely to achieve community ambulation after four weeks compared to those with speeds ≤0.43 m/s (B=2.178, p<.037). The post-training cut-off value of 0.65 m/s had a sensitivity of 75%, specificity of 91%, positive predictive value of 50%, negative predictive value of 96%, and overall accuracy of 90% in distinguishing community ambulation. Patients with a post-training 10mWT speed >0.65 m/s were 32 times more likely to achieve community ambulation after four weeks compared to those with speeds ≤0.65 m/s (B=3.466, p<.008).
Conclusion: Walking speed in subacute stroke patients is closely related to walking endurance and is a crucial predictor of community ambulation. To enhance community ambulation ability, rehabilitation interventions should aim for a minimum walking speed of 0.43–0.65 m/s, with an emphasis on walking endurance training.