Early rehabilitation and gait speed associate with recovery after stroke, finds Ole Petter Norvang in his PhD thesis.
- Stroke patients increase their time spent sitting and upright during the hospital stay.
- Improved spatiotemporal gait parameters three months after stroke link to better balance and walking capacity.
- Gait speed after stroke associates with managing activities of daily living independently at three months follow-up.
Thesis: Recovery after stroke. The importance of early rehabilitation and gait speed
Candidate: Ole Petter Norvang
Time: October 16, 2020 at 12:15
Place: Online-based solution, due to the covid-19 situation
Link to university website (in Norwegian)
(1) Older patients with more severe strokes spend more time sitting during the hospital stay. Time spent sitting and time spent upright increases gradually during hospitalization. The more time patients spent upright, the greater they improved their score on the Modified Rankin Scale. The patients who spent most time in the upright position also had higher Short Physical Performance Battery scores.
In the study, 58 patients admitted to hospital within seven days after stroke onset used body-worn sensors to measure physical activity and how activity levels changed over time during hospitalization.
(2) Stroke patients who improve their gait speed the most during early rehabilitation, also improve walking capacity and balance more than other patients.
Spatiotemporal gait parameters, walking capacity and balance were measured in 79 patients within two weeks of stroke onset, and again three months later. Improvement in nearly all gait parameters were associated with increased balance and walking capacity. In the multivarate analyses, only gait speed remained significant.
(3) Higher gait speed also associates with higher independence in basic activities of daily living three months after stroke. The association is independent of confounders such as fatigue at baseline, age, and stroke severity. Resilience, on the other hand, did not show and relation to activities of daily living at follow-up. 64 patients completed this study.
(1) Norvang, O. P., Hokstad, A., Taraldsen, K., Tan, X., Lydersen, S., Indredavik, B., & Askim, T. (2018). Time spent lying, sitting, and upright during hospitalization after stroke: a prospective observation study. BMC neurology, 18(1), 138.
(2) Norvang, O. P., Askim, T., Egerton, T., Dahl, A. E., & Thingstad, P. (2020). Associations between changes in gait parameters, balance, and walking capacity during the first 3 months after stroke: a prospective observational study. Physiotherapy Theory and Practice, 1-9.
(3) Association between gait speed and resilience during hospitalization with independence in basic activities of daily living three months after a stroke: A prospective longitudinal cohort study. Currently unpublished