Classification of walking ability of household walkers versus community walkers based on K-BBS, gait velocity and upright motor control.

BACKGROUND

Few guidelines are available to assist clinicians with assessment of whether a patient is a household or community walker.

AIM

To assess the Korean Berg balance scale (K-BBS) and gait velocity cut-off points of a household walker versus a community walker and evaluate which combinations of the three scales (K-BBS, upright motor control test (UMCT), and gait velocity) best assessed walking ability.

DESIGN

Cross-sectional study.

SETTING

Outpatient.

POPULATION

A total of 124 stroke patients with walking difficulty.

METHODS

Participants were classified into one of six walking classifications (three household walkers and three community walkers) and K-BBS, UMCT, and gait velocity were evaluated. The optimal cut-off scores for walking classification were determined based on received operator characteristic (ROC) analyses.

RESULTS

The cut-off value of K-BBS for dividing the household walker versus the community walker was 42 points. The cut-off value of gait velocity was 48 m/s for the community walker. The area under the ROC curve of the combined K-BBS and gait velocity values was larger than that of each individual scale and those of the other combined scales.

CONCLUSION

The results suggest that K-BBS, gait velocity, and UMCT are useful instruments for classifying household ambulation and community ambulation. The authors recommend K-BBS as single scale and K-BBS and gait velocity as combined scales for evaluating community ambulation in stroke patients

CLINICAL REHABILITATION IMPACT

In this report, we have some clinical implication. We recommend 3 outcome measures to assess walking ability about home or community; K-BBS (>42 points), gait speed (>48 m/min), UMCT (strong grade in either knee flexion of extension). Suggesting cut-off points of Korean Berg balance scale, gait velocity, and level of upright motor control test for community ambulation could be used as outcome measures to evaluate patient's actual performance level. It is also important to combine several scales for determining walking classification. We suggest to evaluate walking ability by combining K-BBS and UMCT to best predict community ambulation.