Abstract
Purpose: The purpose of this study was to determine which admission clinical assessment or assessments best predict independent walking at discharge (IW-DC) among adults with unilateral impairments hospitalized for rehabilitation post-stroke. Method: On admission, we collected measures of balance (Berg Balance Scale [BBS]), physical function (Chedoke McMaster Stroke Assessment - Activity Inventory), postural and leg motor control (Chedoke McMaster Stroke Assessment - Impairment Inventory), functional independence (FIM), sensation and proprioception, and pushing behaviour (Four-Point Pusher Score). Logistic regression determined which measures influenced the odds of IW-DC. A receiver operating characteristic (ROC) curve determined the cut-points for variables retained in a multivariable model. Results: Data were available for 68 participants, aged a median of 57 (interquartile range [IQR] 16) years, who had received inpatient rehabilitation for a median of 8 (IQR 10) weeks. The odds of IW-DC were reduced with greater impairments in motor control, sensation, or proprioception and with pusher behaviour and increased with lesser impairments in balance, physical function, and functional independence. Only the BBS was retained in the multivariable model (OR 1.23; 95% CI: 1.02, 1.49). An admission BBS score of 14 or more points (sensitivity 0.73; specificity 0.89) predicted IW-DC (area under the ROC curve 0.81; 95% CI: 0.71, 0.92). Conclusions: Among adult stroke survivors, a BBS score of 14 or more provides information on the odds of achieving IW-DC.