Prognostic accuracy of the Stroke Rehabilitation Assessment of Movement (STREAM) scores on admission for walking independence in stroke patients at discharge and one-month follow-up

Any prognostication is ABSOLUTELY FUCKING WORTHLESS IN GETTING SURVIVORS RECOVERED! I'd have you all fired!

 Prognostic accuracy of the Stroke Rehabilitation Assessment of Movement (STREAM) scores on admission for walking independence in stroke patients at discharge and one-month follow-up

PLOS ONE | https://doi.org/10.1371/journal.pone.0319682 March 7, 2025 1 / 14
OPEN ACCESS
Citation: Kirdthongkham T, Justine M,
Siriphorn A (2025) Prognostic accuracy of the
Stroke Rehabilitation Assessment of Movement
(STREAM) scores on admission for walking
independence in stroke patients at discharge
and one-month follow-up. PLoS ONE 20(3):
e0319682. https://doi.org/10.1371/journal.
pone.0319682
Editor: Jyotindra Narayan, Imperial College
London, UNITED KINGDOM OF GREAT
BRITAIN AND NORTHERN IRELAND
Received: October 10, 2024
Accepted: February 6, 2025
Published: March 7, 2025
Copyright: © 2025 Kirdthongkham et al. This
is an open access article distributed under the
terms of the Creative Commons Attribution
License, which permits unrestricted use,
distribution, and reproduction in any medium,
provided the original author and source are
credited.
Data availability statement: All relevant data
are within the manuscript and its Supporting
Information files.
Funding: The 90th Anniversary
of Chulalongkorn University Fund
RESEARCH ARTICLE
Prognostic accuracy of the Stroke
Rehabilitation Assessment of Movement
(STREAM) scores on admission for walking
independence in stroke patients at discharge
and one-month follow-up
Thamonwan Kirdthongkham1,2, Maria Justine1,3, Akkradate Siriphorn 1*
1 Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok,
Thailand, 2 Department of Physical Therapy, Queen Savang Vadhana Memorial Hospital, Chonburi,
Thailand, 3 Centre for Physiotherapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA,
Puncak Alam Campus, Selangor, Malaysia
* Akkradate.s@chula.ac.th

Abstract

Gait prediction is critical in optimizing rehabilitation strategies for stroke survivors. This
study evaluates the prognostic utility of the Stroke Rehabilitation Assessment of Move-
ment (STREAM) scores, recorded at admission, for predicting walking ability at discharge
and one-month follow-up. We assessed 47 stroke patients using STREAM at admission;
walking independence was defined using two criteria: a Functional Ambulation Category
(FAC) score > 3 and a 10-Meter Walk Test (10-MWT) speed ≥ 0.4 m/s. The predictive
validity of STREAM scores was analyzed using the area under the receiver operating
characteristic curve (AUC). Sensitivity, specificity, and cut-off values were computed. The
analysis revealed that a STREAM score above 38 at admission significantly predicted
independent gait by discharge, evidenced by a high AUC of 0.897. At the one-month
follow-up, a cut-off score of 29 continued to predict walking independence, with an AUC of
0.987. The subscores further enhanced predictive accuracy and highlighted the effective-
ness of the STREAM assessment as a robust predictor of independent walking in stroke
patients. These findings suggest the practicality of using STREAM scores to predict walk-
ing independence, which can guide the planning of more effective rehabilitation interven-
tions. Trial registration TCTR20240323004 at www.thaiclinicaltrials.org.