@article{ref1,
title="Balance impairment limits ability to increase walking speed in individuals with chronic stroke",
journal="Disability and rehabilitation",
year="2016",
author="Middleton, Addie and Braun, Carty H. and Lewek, Michael D. and Fritz, Stacy L.",
volume="39",
number="5",
pages="497-502",
abstract="PURPOSE Determine the relationship between balance impairments and the ability to increase walking speed (WS) on demand in individuals with chronic stroke. <br><br>METHODS WS and Berg Balance Scale (BBS) data were collected on 124 individuals with chronic stroke (>6 months). The ability to increase WS on demand (walking speed reserve, WSR) was quantified as the difference between participants' self-selected (SSWS) and maximal (MWS) walking speeds. Correlation, regression and receiver operating characteristic (ROC) analyses were performed to investigate the relationship between balance and the ability to increase WS. <br><br>RESULTS Of sample, 58.9% were unable to increase WS on demand (WSR < 0.2 m/s). BBS scores were associated with WSR values (rs=0.74, 0.65-0.81) and were predictive of 'able/unable' to increase WS [odds ratio (OR) = 0.75, 0.67-0.84]. The AUC for the ROC curve constructed to assess the accuracy of BBS to discriminate between able/unable to increase WS was 0.85 (0.78-0.92). A BBS cutscore of 47 points was identified [sensitivity: 72.6%, specificity: 90.2%, +likelihood ratio (LR): 7.41, -LR: 0.30]. <br><br>CONCLUSIONS The inability to increase WS on demand is common in individuals with chronic stroke, and balance appears to be a significant contributor to this difficulty. A BBS cutscore of 47 points can identify individuals who may benefit from balance interventions to improve the ability to increase their WS. Implications for Rehabilitation A majority of individuals with chronic stroke may be unable to increase their walking speed beyond their self-selected speed on demand. This may limit functional ambulation, as these individuals are walking &quot;at capacity&quot;. Balance impairments contribute to the inability to increase walking speed. A Berg Balance Scale score <47 points can be used to identify individuals with chronic stroke walking &quot;at capacity&quot; due to balance impairments.<p /> <p>Language: en</p>",
language="en",
issn="0963-8288",
doi="10.3109/09638288.2016.1152603",
url="http://dx.doi.org/10.3109/09638288.2016.1152603"
}