Authors (including presenting author) :
Chan WS, Lam PYW, Wong MC
Affiliation :
Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, HKSAR
Introduction :
Stroke patients often experience difficulties in walking which causes caring issue, improving walking is a main goal of rehabilitation. In general, greater intensity of therapy results in better outcome and intensity often refers to frequency and duration of rehabilitation. However, no well accepted definition of ambulation training intensity and target dosage were found in the literature. In TPH, we standardize the use of metric system (meter) as a measurement for ambulation intensity and investigate the minimal ambulation training intensity needed to improve functional mobility of patients.
Objectives :
To standardize the measurement of ambulation training intensity in subacute stroke inpatient rehabilitation and investigate its effect on patients’ functional mobility
Methodology :
To standardize the measurement of intensity using metric system, distance (m) all major ambulation pathways in PT gyms were measured and marked using measurement wheel and marker. All staff received training about the standardization of measuring ambulation intensity. To modernize and accurately document the ambulation intensity, total training distance (meter) of over-ground walking and robotic walking was documented in an electronic database.
Stroke patients with admission MFAC 3-4 in TPH between July and Dec 2022 were included. Their total ambulation training intensity and Modified Functional Ambulation Category (MFAC) were measured to investigate the minimal ambulation intensity needed for assisted walkers to become non-assisted walkers i.e. MFAC 5 or above.
Result & Outcome :
Standardization of measurement and documentation of ambulation intensity help quantify the training intensity for stroke patients. Patients who achieved a minimal ambulation training intensity of at least 3200-meter in inpatient rehabilitation could improve functional level to non-assisted walker (MFAC 5-6) which could facilitate discharge-to-home. In the future, the dose-response relationship in rehabilitation can be further explored. There were 40 patients with admission MFAC 3-4 completed the program. Upon discharge, Group A: 21 out of 40 improved ambulation mobility and became non-assisted walkers i.e. MFAC 5-6, while Group B: 19 out of 40 remained as assisted walkers (MFAC 3-4). Statistically analysis was performed between Group A and Group B. Both groups were similar in age (67 vs 70), Premorbid MFAC (6.9 vs 6.4), length of training (22-day vs 19-day) However, there was a statistically significant difference in ambulation training intensity, Group A: 3144-meter VS Group B: 1179-meter, P < 0.05.
