Volume 51 Number 1, 2014
Pages 39 — 50
Abstract — Prediction of responders for outcome measures of Locomotor Experience Applied Post Stroke trial
Bruce H. K. Dobkin, MD;1* Stephen E. Nadeau, MD;2–3 Andrea L. Behrman, PT, PhD;4 Samuel S. Wu, PhD;5 Dorian K. Rose, PT, PhD;3,6 Mark Bowden, PT, PhD;7 Stephanie Studenski, PT, PhD;8 Xiaomin Lu, PhD;5 Pamela W. Duncan, PT, PhD9
1Department of Neurology, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; 2Department of Neurology, College of Medicine, University of Florida, Gainesville, FL; 3Research Service, Malcom Randall Department of Veterans Affairs (VA) Medical Center, Gainesville, FL; 4Department of Neurological Surgery, University of Louisville, Louisville, KY; 5Department of Biostatistics, University of Florida, Gainesville, FL; 6Department of Physical Therapy, University of Florida, Gainesville, FL; 7Department of Health Science and Division of Physical Therapy, Medical University of South Carolina, and Ralph H. Johnson VA Medical Center, Charleston, SC; 8Department of Internal Medicine, University of Pittsburgh, and Geriatric Research Education and Clinical Centers, VA Pittsburgh Health System, Pittsburgh, PA; 9Department of Neurology, Wake Forest University, Winston-Salem, NC
Abstract — The Locomotor Experience Applied Post Stroke rehabilitation trial found equivalent walking outcomes for body weight-supported treadmill plus overground walking practice versus home-based exercise that did not emphasize walking. From this large database, we examined several clinically important questions that provide insights into recovery of walking that may affect future trial designs. Using logistic regression analyses, we examined predictors of response based on a variety of walking speed-related outcomes and measures that captured disability, physical impairment, and quality of life. The most robust predictor was being closer at baseline to the primary outcome measure, which was the functional walking speed thresholds of 0.4 m/s (household walking) and 0.8 m/s (community walking). Regardless of baseline walking speed, a younger age and higher Berg Balance Scale score were relative predictors of responding, whether operationally defined by transitioning beyond each speed boundary or by a continuous change or a greater than median increase in walking speed. Of note, the cutoff values of 0.4 and 0.8 m/s had no particular significance compared with other walking speed changes despite their general use as descriptors of functional levels of walking. No evidence was found for any difference in predictors based on treatment group.
Clinical Trial Registration: ClinicalTrials.gov; NCT00243919, "Locomotor Experience Applied Post Stroke Trial";
http://www.clinicaltrials.gov
http://www.clinicaltrials.gov
Key words: community ambulation, exercise, functional walking level, gait speed, LEAPS, outcome measures, physical therapy, quality of life, stroke rehabilitation, walking.
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This article and any supplementary material should be cited as follows:
Dobkin BH, Nadeau SE, Behrman AL, Wu SS, Rose DK, Bowden M, Studenski S, Lu X, Duncan PW. Prediction of responders for outcome measures of Locomotor Experience Applied Post Stroke trial. J Rehabil Res Dev. 2014;51(1):39–50.
http://dx.doi.org/10.1682/JRRD.2013.04.0080
Dobkin BH, Nadeau SE, Behrman AL, Wu SS, Rose DK, Bowden M, Studenski S, Lu X, Duncan PW. Prediction of responders for outcome measures of Locomotor Experience Applied Post Stroke trial. J Rehabil Res Dev. 2014;51(1):39–50.
http://dx.doi.org/10.1682/JRRD.2013.04.0080
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Last Reviewed or Updated Tuesday, April 8, 2014 11:49 AM
