Deans' stroke musings: “Considerations for the selection of time-limited walk tests post-stroke: A systematic review of test protocols and measurement properties”

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, October 23, 2016

“Considerations for the selection of time-limited walk tests post-stroke: A systematic review of test protocols and measurement properties”

Proving once again that every stroke survivor is a one person guinea pig in a research trial for your doctor. I bet your doctor hasn't registered that trial with the appropriate review bodies. Stroke survivors have absolutely nothing defined in valid protocols, total fucking incompetency in the stroke medical world. On your own again. I never had the 6 minute walk test, only the timed up and go and the 10 meter there and back. All of which I thought were useless. Tests that had no bearing on getting you better.
https://jnptacceptedarticles.wordpress.com/2016/10/23/just-accepted-considerations-for-the-selection-of-time-limited-walk-tests-post-stroke-a-systematic-review-of-test-protocols-and-measurement-properties/
The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:
“Considerations for the selection of time-limited walk tests post-stroke: A systematic review of test protocols and measurement properties”
By
Nancy Salbach, PT, PhD; Kelly K O’Brien, PhD; Dina Brooks, PhD; Emma Irvin, BA; Rosemary Martino, PhD; Pam Takhar, MSc; Sylvia Chan, BScPT; Jo-Anne Howe, BScPT
Provisional Abstract:
Background and Purpose: Systematic reviews of research evidence describing the quality and methods for administering standardized assessment tools are essential to developing recommendations for their clinical application. The purpose of this systematic review was to synthesize the research literature describing test protocols and measurement properties of time-limited walk tests in people post-stroke.
Methods: Following an electronic search of seven bibliographic databases, two authors independently screened titles and abstracts. One author identified eligible articles, and performed quality appraisal and data extraction.
Results: Of 12,180 records identified, 43 articles were included. Among five walk tests described, the 6-minute walk test (6MWT) was most frequently evaluated (n=36). Only 5 articles included participants in the acute phase (<1 month) post-stroke. Within tests, protocols varied. Walkway length and walking aid, but not turning direction influenced 6MWT performance. Intraclass correlation coefficients for reliability were 0.68-0.71 (12MWT) and 0.80-1.00 (2-, 3-, 5- and 6MWT). Minimal detectable change values at the 90% confidence level were 11.4m (2MWT), 24.4m (5MWT), and 27.7-52.1m (6MWT; n=6). Moderate-to-strong correlations (≥0.5) between 6MWT distance and balance, motor function, walking speed, mobility, and stair capacity were consistently observed (n=33). Moderate-to-strong correlations between 5MWT performance and walking speed/independence (n=1), and between 12MWT performance and balance, motor function, and walking speed (n=1) were reported.
Discussion and Conclusions: Strong evidence of the reliability and construct validity of using the 6MWT post-stroke exists; studies in the acute phase are lacking. Given protocol variations influence performance, a standardized 6MWT protocol post-stroke for use across the care continuum is needed (Supplemental Digital Content 1-Video abstract).
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