Abstract
Gait disturbance due to motor paralysis affects activities of daily living and quality of life in patients with stroke. Thus, commencing walking training from the acute phase of recovery is essential. This study aimed to clarify the factors affecting the walking ability of hemiplegic stroke patients. Eighty hospitalized patients with a first chemic or hemorrhagic stroke within 1 year but not less than 1 month after stroke onset were included in this study. The dependent variable was walking ability (Functional Independence Measure [FIM] locomotion score), and the independent variables were spirituality (Spirituality Rating Scale-A [SRS-A]), amount of social support (Japanese version of the Abbreviated Multidimensional Scale of Perceived Social Support, frequency of family visit), stroke severity (National Institutes of Health Stroke Scale [NIHSS]), degree of motor paralysis (lower extremity Brunnstrom stage), the lower limb loading force of the affected and unaffected side, and age. Spearman’s rank correlation coefficient and multiple regression analysis were performed. Multiple regression analysis showed that FIM locomotion score was associated with NIHSS (standard partial regression coefficient = ?0.362, P 0.001), the unaffected lower limb loading force (standard partial regression coefficient = 0.264, P 0.001), lower extremity Brunnstrom stage (standard partial regression coefficient = 0.352, P 0.001), and SRS-A (standard partial regression coefficient = 0.184, P 0.011). From our findings, walking ability was affected by stroke severity and the degree of paralysis, the unaffected lower limb loading force, and the spirituality level in patients with stroke. Promoting walking ability in patients with stroke includes training the unaffected lower limb and heightening spirituality. Training of the unaffected lower limb should be performed at the bedside or on the bed by the patient or a bedside nurse. To heighten spirituality, nurses who care for patients with stroke are encouraged to practice active listening and to show sympathy as part of emotional support and spiritual care.
Highlights
Hemiplegic stroke patients often experience gait disturbance, such as spastic gait, due to motor paralysis
SRS-A correlated with the Japanese version of the Abbreviated Multidimensional Scale of Perceived Social Support (r = 0.478, P < 0.001)
Multiple regression analysis showed that Functional Independence Measure (FIM) locomotion score was related to National Institutes of Health Stroke Scale (NIHSS), the unaffected lower limb loading force, the lower extremity Brunnstrom stage, and SRS-A
Summary
Hemiplegic stroke patients often experience gait disturbance, such as spastic gait, due to motor paralysis. Since social support and spirituality affect patients’ mental condition, assessing and enhancing social support and spirituality, as well as motivation in these patients are necessary to aid the recovery of walking ability. In the early rehabilitation of patients with acute stroke, it is reported that shorter, more frequent mobilization results in favorable outcomes and walking by 3 months, with a decrease in mortality rate and complications [8]. Assisting these patients with rehabilitation from an early stage in the ward is necessary to accelerate recovery
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