Affiliations: [a] Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
| [b] Department of Physical Therapy College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| [c] Brain Rehabilitation Research Center, North Florida/South Georgia VA Medical Center, Gainesville, FL, USA
| [d] Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| [e] Neurovascular Division and Stroke Program, Department of Neurology, Barrow Neurological Institute at Dignity Health St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
Correspondence:
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Address for correspondence: Janis J. Daly, Ph.D., Brain Rehabilitation Research Center; Malcom Randall Gainesville VA Medical Center; 1601 SW Archer Rd; Gainesville, FL, USA. Tel.: +1-216-402-8940; E-mail: jjd17@case.edu.
Abstract: BACKGROUND:Gait deficits and functional disability are persistent problems for many stroke survivors, even after standard neurorehabilitation. There is little quantified information regarding the trajectories of response to a long-dose, 12-month intervention. OBJECTIVE:We quantified treatment response to an intensive neurorehabilitation mobility and fitness program. METHODS:The 12-month neurorehabilitation program targeted impairments in balance, limb coordination, gait coordination, and functional mobility, for five chronic stroke survivors. We obtained measures of those variables every two months. RESULTS:We found statistically and clinically significant group improvement in measures of impairment and function. There was high variation across individuals in terms of the timing and the gains exhibited. CONCLUSIONS:Long-duration neurorehabilitation (12 months) for mobility/fitness produced clinically and/or statistically significant gains in impairment and function. There was unique pattern of change for each individual. Gains exhibited late in the treatment support a 12-month intervention. Some measures for some subjects did not reach a plateau at 12 months, justifying further investigation of a longer program (>12 months) of rehabilitation and/or maintenance care for stroke survivors.
Keywords: Stroke, gait, balance, coordination, gait speed, functional mobility, quality of life
