Performance and capacity-based measures of locomotion, compared to impairment-based measures, best predicted participation in individuals with hemiparesis due to stroke

Abstract

Purpose: To determine the potential predictors of participation of individuals with post-stroke hemiparesis, taking into account modifiable variables of impairments, activity limitations, and environmental factors.

Methods: One hundred and nine individuals (58 ± 12 years; 64 men) participated in this study. Outcomes included measures of impairments (depressive symptoms: Geriatric Depression Scale and motor-based impairments: finger-to-nose test, lower extremity (LE) motor coordination test, and handgrip strength, isometric strength of the LE muscles), activity (capacity: 10-meter walking speed test and Test d'Évaluation des Membres Supérieurs de Personnes Agées; performance: locomotion and manual abilities; environmental factors (Measure of the Quality of the Environment); and participation: Assessment of Life Habits (LIFE-H 3.1 Brazil)).

Results: Regression analyses revealed that the explanatory variables accounted for 59% and 49% of the variance in the LIFE-H 3.1 Brazil daily activity and social role sub-scales, respectively. Locomotion performance (R² = 39%; p < 0.0001) and walking speed (R² = 32%; p < 0.0001) were the best predictors of the LIFE-H 3.1 Brazil daily activity and social role sub-scales, respectively. Depressive symptoms were the only impairments, which were retained in both models.

Conclusions: Performance and capacity-based measures of locomotion showed to be the best predictors of participation. Additionally, depressive symptoms should not be underlooked. Implications for Rehabilitation Activity-related measures of locomotion showed to be the main predictors of participation in individuals with post-stroke hemiparesis, as assessed by the daily activity and social role sub-scales of the LIFE-H 3.1. The daily activity model was best predicted by measures of performance, whereas the social role sub-scale, by measures of capacity. Although small, the impact of depressive symptoms on participation should not be underlooked. Locomotion appeared to be essential for participation and increases in walking speed and locomotion ability should be the main goals for both professionals and individuals, when the aim is to increase participation.

Keywords: Stroke; rehabilitation; social participation.