Classification of Household VS. Community Walker by K-BBS, Walking Speed, and Upright Motor Control

초록

Objective: The limited walking ability that follows a stroke restricts the patient’s independent mobility about the home and community. Few guidelines are available, however, to assist the clinician to assess whether patient can be household walker or community walker. We, therefore, plan to evaluate the relationship among the walking speed, the Korean berg balance scale (K-BBS)1, the upright motor control (UMC)2, and the classification of walking ability (household walker or community walker). Our goals are to assess the K-BBS & the gait speed cut-off points for classifying household walker versus community walker and to evaluate whether UMC could be used to assess walking ability. Methods: Thirty eight stroke patients with walking difficulty were enrolled. Patient was classified to one of six Hoffer walking classification (household walker; physiologic, limited, unlimited or community walker; most-limited, least-limited, normal). K-BBS was evaluated and GAITRite3 performed to evaluate gait speed. UMC test of knee flexion and extension was done by one physical therapist. Knee flexion and extension grading (weak, moderate & strong) were measured by degree of flexion or extension and maintenance time. Data were analyzed by ROC (receiver operating characteristic) curve technique to obtain each cutoff value of the K-BBS and gait speed to classify household walker versus community walker. Sensitivity and specificity of UMC results to evaluate walking classification were analyzed. Results: There was significant correlation among walking classification (household walker and community walker), the K-BBS, and the gait speed. The cut-off value of K-BBS for dividing household walker versus community walker was 43 points (sensitivity: 88%, specificity: 100%). The cut-off value of gait speed was 48.8m/s for community walker (sensitivity: 92%, specificity: 85%). If either knee flexion or extension score was 3 (grade strong), the predicted walking categor