Deans' stroke musings: Factors associated with time to independent walking recovery post-stroke

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.

Tuesday, June 15, 2021

Factors associated with time to independent walking recovery post-stroke

Useless. You give us nothing on how to change those factors to get to 100% recovery

And your mentors and senior researchers were OK with such lousy outcomes?

Factors associated with time to independent walking recovery post-stroke

http://orcid.org/0000-0002-3344-4674Caitlin Kennedy1,
http://orcid.org/0000-0002-2787-8484Julie Bernhardt2,3,
http://orcid.org/0000-0002-9807-6606Leonid Churilov1,
http://orcid.org/0000-0003-2950-4870Janice M Collier2,
http://orcid.org/0000-0002-7302-1895Fiona Ellery2,
http://orcid.org/0000-0002-0493-8536Venesha Rethnam2,
http://orcid.org/0000-0002-9803-7631Lilian B Carvalho2,3,
http://orcid.org/0000-0001-6324-3403Geoffrey A Donnan4,5,
http://orcid.org/0000-0001-5240-3264Kathryn S Hayward2,3,6

Correspondence to Dr Kathryn S Hayward, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC 3010, Australia; kate.hayward@unimelb.edu.au

Abstract

Background Past studies have inconsistently identified factors associated with independent walking post-stroke. We investigated the relationship between pre-stroke factors and factors collected acutely after stroke and number of days to walking 50 m unassisted using data from A Very Early Rehabilitation Trial (AVERT).

Methods The outcome was recovery of 50 m independent walking, tested from 24 hours to 3 months post-stroke. A set of a priori defined factors (participant demographics: age, sex, handedness; pre-stroke: hypertension, ischaemic heart disease, hypercholesterolaemia, diabetes mellitus, atrial fibrillation; stroke-related: stroke severity, stroke type, ischaemic stroke location, stroke hemisphere, thrombolysis) were investigated for association with independent walking using a cause-specific competing risk Cox proportional hazards model. Respective effect sizes are reported as cause-specific adjusted HR (caHR) adjusted for age, stroke severity and AVERT intervention.

Results A total of 2100 participants (median age 73 years, National Institutes of Health Stroke Scale 7, <1% missing data) with stroke were included. The median time to walking 50 m unassisted was 6 days (IQR 2–63) and 75% achieved independent walking by 3 months. Adjusted Cox regression indicated that slower return to independent walking was associated with older age (caHR 0.651, 95% CI 0.569 to 0.746), diabetes (caHR 0.836, 95% CI 0.740 to 0.945), severe stroke (caHR 0.094, 95% CI 0.072 to 0.122), haemorrhagic stroke (caHR 0.790, 95% CI 0.675 to 0.925) and right hemisphere stroke (caHR 0.796, 95% CI 0.714 to 0.887).

Conclusion Our analysis provides robust evidence for important factors associated with independent walking recovery. These findings highlight the need for tailored mobilisation programmes that target subgroups, in particular people with haemorrhagic and severe stroke.