Determining stroke recovery can be challenging. Two areas I am commonly asked about by people after stroke are the recovery of walking and arm function. In this week’s blog, I would like to focus on the recovery of walking.
There is a lot of research to guide health professionals in their recommendations about post-stroke walking outcomes, however, none of the indicators of recovery are perfect and we need to consider many factors about the individual person.
The first thing you should know is that most people have a good recovery of walking after stroke. For example, 80% of people who are hospitalized after stroke will walk again (1). If you can’t walk initially after your stroke you have about a 60% chance of walking after stroke rehabilitation (2,3).
What predicts who will and who won’t have a good recovery of walking?
There are a number of factors that can indicate if you will be able to walk again and how well. These center around age, physical ability, and stroke severity, with older people and people with more severe strokes having less ability to recover their walking (4).
But what about all the therapy I’m doing? Does that matter?
I have been interested in this question for many years, and I have done quite a bit of research in this area.
Interestingly in the work I’ve done, ability to engage in repetitive practice within therapy was the best indicator of the recovery of walking (1). This was in terms of both the ability to walk and the time taken to achieve independent walking. These results suggest to me that in spite of age and stroke severity, ability to practice may be the key factor in stroke recovery.
Further research I’ve conducted showed a clear relationship between how much therapy is completed and walking outcomes. Meaning that for more practice each day there was an improvement in walking speed.
What if I’m frustrated with the recovery of my walking?
If you are unable to walk or would like to walk better you need to ask yourself and your therapists a few key questions.
- Have I done enough practice?
- Have I done the right practice?
- How important is this goal to me? Am I willing to commit my time and work hard to achieve it?
- Are there other solutions? What aids and equipment could I use?
For some people, the answer will be simple and you can talk to your physiotherapist about what to do to achieve your goals. For others, it will be harder and you may want to consider other options including wheelchairs and scooters to improve your mobility. Your physiotherapist can assist you with these decisions.
If you have any questions please don’t hesitate to contact us.
Dr Kate Scrivener
- Scrivener K, Sherrington C, Schurr K. Exercise dose and mobility outcome in a comprehensive stroke unit: description and prediction from a prospective cohort study. Journal of Rehabilitation Medicine. 2012; 44:823-9.
- Scrivener K, Sherrington C, Schurr K. Amount of exercise in the first week after stroke predicts walking speed and unassisted walking. Neurorehabilitation and Neural Repair. 2012;26:932-8.
- Preston E, Ada L, Dean CM, Stanton R, Waddington G. What is the probability of patients who are nonambulatory after stroke regaining independent walking? A systematic review. International Journal of Stroke. 2011;6:531-40.
- Craig LE, Wu O, Bernhardt J, Langhorne P. Predictors of poststroke mobility: systematic review. International Journal of Stroke. 2011;6:321-7.