TY - JOUR PY - 2021// TI - Prediction of independent walking in people who are nonambulatory early after stroke: a systematic review JO - Stroke A1 - Preston, Elisabeth A1 - Ada, Louise A1 - Stanton, Rosalyn A1 - Mahendran, Niruthikha A1 - Dean, Catherine M. SP - ePub EP - ePub VL - ePub IS - ePub N2 - BACKGROUND AND PURPOSE: One systematic review has examined factors that predict walking outcome at one month in initially nonambulatory patients after stroke. The purpose of this systematic review was to examine, in nonambulatory people within a month of stroke, which factors predict independent walking at 3, 6, and 12 months.

METHODS: Prognostic factors: Any factors measured within one month after stroke with the aim of predicting independent walking. Outcome of interest: Independent walking defined as walking with or without an aid but with no human assistance.

RESULTS: Fifteen studies comprising 2344 nonambulatory participants after stroke were included. Risk of bias was low in 7 studies and moderate in 8 studies. Individual meta-analyses of 2 to 4 studies were performed to calculate the pooled estimate of the odds ratio for 12 prognostic factors. Younger age (odds ratio [OR], 3.4, P<0.001), an intact corticospinal tract (OR, 8.3, P<0.001), good leg strength (OR, 5.0, P<0.001), no cognitive impairment (OR, 3.5, P<0.001), no neglect (OR, 2.4, P=0.006), continence (OR, 2.3, P<0.001), good sitting (OR, 7.9, P<0.001), and independence in activities of daily living (OR 10.5, P<0.001) predicted independent walking at 3 months. Younger age (OR, 2.1, P<0.001), continence (OR, 13.8, P<0.001), and good sitting (OR, 19.1, P<0.001) predicted independent walking at 6 months. There were insufficient data at 12 months.

CONCLUSIONS: Younger age, an intact corticospinal tract, good leg strength, continence, no cognitive impairment, no neglect, good sitting, and independence in activities of daily living in patients who are nonambulatory early after stroke predict independent walking at 3 months. Registration: URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42018108794.

Language: en

LA - en SN - 0039-2499 UR - http://dx.doi.org/10.1161/STROKEAHA.120.032345 ID - ref1 ER -