Stair walking is associated with returning home after inpatient stroke rehabilitation in Belgium and Switzerland: a multicentric retrospective study

 Did your therapist identify EXACTLY YOUR PROBLEMS IN STAIR CLIMBING? Like specifying exactly what muscles need work according to this diagram. My hamstrings don't fire properly, something my therapists never found and obviously never fixed. Now that I have a four level condo I can slow down and climb stairs correctly instead of circumducting.

With this series of images from Nathan Nicholson I finally got the understanding that you don't just lift the foot straight up, you  engage your hamstring to pull your leg up behind you at the same time pointing your toes down(plantarflexion) to clear the lip of the step. I have to plan this all out on my own since most of my premotor cortex is dead. This currently is a very slow process.
1. Engage the hamstring
2. Point the toes down - plantarflexing 
3. Clear the step
4. Dorsiflex to lift the toe up
5. Straighten the leg 

Stair walking is associated with returning home after inpatient stroke rehabilitation in Belgium and Switzerland: a multicentric retrospective study

Odile Chevalley ^1,2, , Emmanuelle Opsommer ¹, Steven Truijen ², Grégoire Eberlé ³, Isabelle Lehmann ⁴, Katrien Van Den Keybus Déglon ³, Wim Saeys ²

PMCID: PMC12856565  PMID: 41623684

ABSTRACT

Introduction:

Identifying factors associated with discharge destination after inpatient stroke rehabilitation is important for patients and healthcare professionals. It supports discharge planning and prevents delayed discharge.

Objective:

To identify key variables from socio-demographic and clinical data associated with returning home after inpatient stroke rehabilitation, focusing on patients from three rehabilitation centers in Belgium and Switzerland.

Methods:

This multicenter retrospective study, conducted in three centers, included 1475 adult patients with stroke admitted to an inpatient rehabilitation unit between December 2012 and June 2021. A logistic regression with backward selection was used to define the model for discharge destination. The dependent variable was the discharge destination (home vs other). The independent variables were selected from the socio-demographic, medical, neurological, care pathway, and functional data and included age, gender, living arrangement, type of stroke, previous stroke, cognitive impairments, independence in grooming, eating, and stair walking.

Results:

The final model included three variables (independence in stair walking, living arrangement, and cognitive impairment). Stair walking had the strongest association with returning home. Patients who were partially (OR 5.83, 95% CI 3.67-9.26) or fully independent (OR 14.31, 95% CI 9.34-21.93) were more likely to return home than patients who were unable to walk the stairs. The results were similar for subgroups and for discharge and admission data.

Conclusion:

The study showed that independence in walking stairs is strongly associated with discharge destination. Aligned with another study, these results should be confirmed in further research.