Development of an independent ambulation rating chart for post-stroke hemiplegic patients in the recovery stage: at what level is patients free to walk within rehabilitation ward

Osada Y, Simabukuro M, Iwasaki Y, Kaneko K, Fuchi M, Ibayashi S. Development of an independent ambulation rating chart for post-stroke hemiplegic patients in the recovery stage: at what level is patients free to walk within rehabilitation ward. Jpn J Compr Rehabil Sci 2015; 6: 143-150. Objective: This study aimed to identify subjective and objective assessment items to rate independent ambulation in hemiplegic patients, and to develop an effective independent ambulation rating chart. Methods: Logistic regression analyses were conducted on subjective assessment items extracted from a questionnaire survey of 25 physical therapists and on objective assessment items using the Fugl-Meyer Assessment (FMA) to identify factors that influence independent ambulation in hemiplegic patients. The factors identified were used to construct an independent ambulation rating chart. Forty-five hemiplegic patients were assessed using the chart, and the concordance with the actual independence status was analyzed. Results: Unsteadiness, distribution of attention, associated reaction, and balance subscale of FMA were identified as factors influencing independent ambulation. The results obtained from the rating chart constructed using the above factors showed high concordance with the actual independence status. Conclusion: We developed a rating chart from analyzing independent ambulation factors. Since the rating chart assesses higher level brain functions and clinical context including self-management, good concordance with the actual independence status was obtained. The chart is useful for the rating of independence.