Mini-BESTest at 2 and 3 months after stroke onset is associated with walking independence at discharge

Ryosuke Yamamoto, Shin Murata, Shun Sawai, Shoya Fujikawa, Yusuke Shizuka, Kotaro Nakagawa, Hideki Nakano
Purpose:

This study aimed to determine changes over time in factors affecting walking independence in stroke patients at discharge from the hospital.This study aimed to determine changes over time in factors affecting walking independence in stroke patients at discharge from the hospital.

Methods:

In this study, the participants were 22 stroke patients. The Functional Ambulation Category (FAC), Stroke Impairment Assessment Set lower limb motor items, Trunk Control Test, Mini-Balance Evaluation Systems Test (Mini-BESTest), and Functional Independence Measure cognitive items were assessed monthly for three months after stroke onset. A FAC score of less than 4 was defined as a non-walking independent group and a score of 4 or more as a walking independent group. Factors affecting gait independence at discharge were extracted using logistic regression analysis, with gait independence as the dependent variable and other assessment indicators as independent variables. Independent variables were entered by month from 1 month to 3 months. The significance level was set at 5%.

Results:

Using the FAC at discharge, the patients were divided into 14 in the independent walking group and 8 in the non-independent group. Logistic regression analysis showed that clinical assessment 1 month after stroke onset was not extracted as a factor associated with walking independence at discharge (p > 0.05). On the other hand, at 2- and 3-months onset, Mini-BESTest was extracted as a factor significantly associated with walking independence at discharge (p 0.05). The Mini-BESTest has been reported to be a highly accurate predictor of falls in stroke patients. On the other hand, it has been shown that there is a floor effect for acute stroke patients due to the difficulty of the task, whereas there is no ceiling effect for stroke patients in the recovery phase. Therefore, it is possible that the Mini-BESTest at 1 month after stroke onset was not extracted as a factor related to walking independence at discharge. Still, the Mini-BEST at 2 and 3 months after stroke onset was extracted as a relevant factor.

Conclusion(s):

This study suggests the importance of assessing the Mini-BESTest over time, starting at 2 months after stroke onset, in predicting stroke patients' walking independence at discharge.

Implications:

The results of this study may help to establish the prediction of walking independence considering the time from stroke onset.

Funding acknowledgements:
This work was supported by JSPS KAKENHI Grant Numbers JP23K10417, JP23K19907, JP24K23764.
Keywords:
Assessment of Walking Independence
Stroke
longitudinal change
Primary topic:
Neurology: stroke
Second topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Department of Rehabilitation, Tesseikai Neurosurgical Hospital ethics review committee
Provide the ethics approval number:
23-64
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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