The effect of walking training intensity on regaining independent walking for sub-acute stroke patients: A retrospective study.

Background: Recovery of walking ability is important for stroke patients because it increases the likelihood of discharge and is the essential basis for achieving functional independence. Walking training intensity, measured in meters (m), provides a tangible measure of progress that is obvious and directly relates to a patient's ability to walk in real-world scenarios. Objectives: To determine the relationship between walking training distance, m and discharge walking ability of sub-acute stroke patients using modified functional ambulation classification (MFAC), and to compare the achieved walking training distance between two distinct groups; non-assisted and assisted walkers of sub-acute stroke patients and their between-group differences in discharge functional outcomes including modified Rivermead mobility index (MRMI) and Berg's balance scale (BBS). Method: The design was a retrospective study conducted in an inpatient rehabilitation center. A total of 87 patients were assigned to the Non-Assisted Walker group and Assisted Walker group according to their discharge MFAC. The correlation between walking training distance and discharge functional outcomes, and the between-group differences in walking training distance, functional outcomes of MFAC, MRMI and BBS were analyzed. Results: The achieved walking training distance in the Non-Assisted Walker group was significantly ( p < 0 . 001 ) higher than that of the Assisted Walker group. The achieved walking training distance in Non-Assisted Walker group and the Assisted Walker group were 3190 m ± 2636 and 1178 m ± 1145 , respectively. There were significant between-group differences ( p < 0 . 001 ) in discharge MRMI and BBS indicating that the Non-Assisted Walker group achieved better functional outcomes at discharge compared to the Assisted Walker group. The achieved walking training distance had moderate correlations with discharge MFAC ( r = 0 . 53 , p < 0 . 001 ), discharge MRMI ( r = 0 . 54 , p < 0 . 001 ) and discharge BBS ( r = 0 . 47 , p < 0 . 001 ), respectively. Conclusion: The results suggested that higher walking training intensity, as reflected by greater achieved walking training distance, is associated with higher levels of walking ability at discharge and better functional outcomes.