neuroreha 2022; 14(01): 27-33
DOI: 10.1055/a-1729-3431
Schwerpunkt

Gehfähigkeit und Mobilität

Jan Mehrholz
,
Bernhard Elsner

Eines der wichtigsten Rehabilitationsziele nach Schlaganfall ist die Gehfähigkeit. Die Prognosefaktoren sind vielfältig und klinisch leicht zu erheben. Sie umfassen beispielsweise die Gehgeschwindigkeit, die Gangausdauer, die Schrittzahl, die Balance und die Angst vor Stürzen. Zu erleben, wie sich diese Items verbessern, hat womöglich günstige Auswirkungen auf den Langzeitverlauf.



Publication History

Article published online:
14 March 2022

© 2022. Thieme. All rights reserved.

© Georg Thieme Verlag KG
Stuttgart · New York

 
  • Literatur

  • 1 Bonita R, Solomon N, Broad JB. Prevalence of stroke and stroke-related disability: Estimates from the Auckland stroke studies. Stroke 1997; 28: 1898-1902
  • 2 O’Mahony PG, Thomson RG, Dobson R. et al. The prevalence of stroke and associated disability. J Public Health Med 1999; 21: 166-171
  • 3 Bohannon RW. Gait performance of hemiparetic stroke patients: Selected variables. Arch Phys Med Rehabil 1987; 68: 777-781
  • 4 Bowden MG, Balasubramanian CK, Neptune RR. et al. Anterior-posterior ground reaction forces as a measure of paretic leg contribution in hemiparetic walking. Stroke 2006; 37: 872-876
  • 5 Eng JJ, Chu KS, Dawson AS. et al. Functional walk tests in individuals with stroke: Relation to perceived exertion and myocardial exertion. Stroke 2002; 33: 756-761
  • 6 Mehrholz J. Den Gang zuverlässig beurteilen. Zur Gehfähigkeit nach Schlaganfall: Die deutschsprachige Version der „Functional Ambulation Categories“ (FAC) – Reliabilität und konkurrente Validität. Z f Physiotherapeuten 2007; 59: 1096-1102
  • 7 Salbach NM, Mayo NE, Higgins J. et al. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil 2001; 82: 1204-1212
  • 8 Wade D. Measurement in stroke rehabilitation. Oxford: Oxford University Press; 1992
  • 9 Lin JH, Hsu MJ, Hsu HW. et al. Psychometric comparisons of 3 functional ambulation measures for patients with stroke. Stroke 2010; 41: 2021-2025
  • 10 Holden MK, Gill KM, Magliozzi MR. et al. Clinical gait assessment in the neurologically impaired: Reliability and meaningfulness. Phys Ther 1984; 64: 35-40
  • 11 Holden MK, Gill KM, Magliozzi MR. Gait assessment for neurologically impaired patients. Standards for outcome assessment. Phys Ther 1986; 66: 1530-1539
  • 12 Mehrholz J, Wagner K, Rutte K. et al. Predictive validity and responsiveness of the Functional Ambulation Category in hemiparetic patients after stroke. Arch Phys Med Rehabil 2007; 88: 1314-1319
  • 13 Mehrholz J, Thomas S, Kugler J. et al. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev 2020; 10: CD006185 DOI: 10.1002/14651858.CD006185.pub5.
  • 14 Kollen B, Kwakkel G, Lindeman E. Time dependency of walking classification in stroke. Phys Ther 2006; 86: 618-625
  • 15 van Loo MA, Moseley AM, Bosman JM. et al. Inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury. Clin Rehabil 2003; 17: 775-779
  • 16 Green J, Forster A, Young J. Reliability of gait speed measured by a timed walking test in patients one year after stroke. Clin Rehabil 2002; 16: 306-314
  • 17 Ada L, Dean CM, Hall JM. et al. A treadmill and overground walking program improves walking in persons residing in the community after stroke: A placebo-controlled, randomized trial. Arch Phys Med Rehabil 2003; 84: 1486-1491
  • 18 Hesse S, Werner C, Bardeleben A. Apparative Ganganalyse in der neurologischen Rehabilitation. Phys Rehab Kur Med 2000; 29-33
  • 19 Perry J. Gait analysis, normal and pathological function. Thorofare, NJ: Slack Inc; 1992
  • 20 Evans MD, Goldie PA, Hill KD. Systematic and random error in repeated measurements of temporal and distance parameters of gait after stroke. Arch Phys Med Rehabil 1997; 78: 725-729
  • 21 Friedman PJ. Gait recovery after hemiplegic stroke. Int Disabil Stud 1990; 12: 119-122
  • 22 Turnbull GI, Charteris J, Wall JC. A comparison of the range of walking speeds between normal and hemiplegic subjects. Scand J Rehabil Med 1995; 27: 175-182
  • 23 Wagenaar RC, Beek WJ. Hemiplegic gait: A kinematic analysis using walking speed as a basis. J Biomech 1992; 25: 1007-1015
  • 24 Roth EJ, Merbitz C, Mroczek K. et al. Hemiplegic gait: Relationships between walking speed and other temporal parameters. Am J Phys Med Rehabil 1997; 76: 128-133
  • 25 Mehrholz J, Ritschel C, Rückriem S. et al. Geschwindigkeitstraining auf dem Laufband nach Schlaganfall: Eine Einzelfallstudie. Z f Physiotherapeuten 2002; 54: 378-386
  • 26 Robinett CS, Vondran MA. Functional ambulation velocity and distance requirements in rural and urban communities: A clinical report. Phys Ther 1988; 68: 1371-1373
  • 27 Hill K, Ellis P, Bernhardt J. et al. Balance and mobility outcomes for stroke patients: A comprehensive audit. Australian Physiotherapy 1997; 43: 173-180
  • 28 Brandstater ME, de Bruin H, Gowland C. et al. Hemiplegic gait: Analysis of temporal variables. Arch Phys Med Rehabil 1983; 64: 583-587
  • 29 Kwakkel G, Wagenaar RC. Effect of duration of upper- and lower-extremity rehabilitation sessions and walking speed on recovery of interlimb coordination in hemiplegic gait. Phys Ther 2002; 82: 432-448
  • 30 Bohannon RW, Andrews AW. Correlation of knee extensor muscle torque and spasticity with gait speed in patients with stroke. Arch Phys Med Rehabil 1990; 71: 330-333
  • 31 Richards C, Olney S. Hemiparetic gait following stroke. Part II: Recovery and physical therapy. Gait Posture 1996; 4: 149-162
  • 32 Goldie PA, Matyas TA, Evans OM. Deficit and change in gait velocity during rehabilitation after stroke. Arch Phys Med Rehabil 1996; 77: 1074-1082
  • 33 Perry J, Garrett M, Gronley JK. et al. Classification of walking handicap in the stroke population. Stroke 1995; 26: 982-989
  • 34 Jylha M, Guralnik JM, Balfour J. et al. Walking difficulty, walking speed, and age as predictors of self-rated health: The women’s health and aging study. J Gerontol A Biol Sci Med Sci 2001; 56: M609-617
  • 35 Hoeymans N, Feskens EJ, Kromhout D. et al. Ageing and the relationship between functional status and self-rated health in elderly men. Soc Sci Med 1997; 45: 1527-1536
  • 36 Pohl M, Mehrholz J, Ritschel C. et al. Speed-dependent treadmill training in ambulatory hemiparetic stroke patients: A randomized controlled trial. Stroke 2002; 33: 553-558
  • 37 Wade DT. Measurement in neurologic rehabilitation. Curr Opin Neurol 1993; 6: 778-784
  • 38 Wade DT. Neurologic rehabilitation. Curr Opin Neurol 1993; 6: 753-755
  • 39 Richards C, Malouin F, Dumas F. et al. Gait velocity as an outcome measure of locomotor recovery after stroke. In: Craik R, Oatis C. eds. Gait Analysis: Theory and Application. St Louis: Mosby; 1995: 355-364
  • 40 Andriachi T, Ogle J, Galante J. Walking speed as a basis for normal and abnormal gait measures. J Biomech 1977; 10: 262-268
  • 41 Lehmann JF, Condon SM, Price R. et al. Gait abnormalities in hemiplegia: Their correction by ankle-foot orthoses. Arch Phys Med Rehabil 1987; 68: 763-771
  • 42 Olney SJ, Griffin MP, McBride ID. Multivariate examination of data from gait analysis of persons with stroke. Phys Ther 1998; 78: 814-828
  • 43 Hesse SA, Jahnke MT, Bertelt CM. et al. Gait outcome in ambulatory hemiparetic patients after a 4-week comprehensive rehabilitation program and prognostic factors. Stroke 1994; 25: 1999-2004
  • 44 Pomeroy VM, Pramanik A, Sykes L. et al. Agreement between physiotherapists on quality of movement rated via videotape. Clin Rehabil 2003; 17: 264-272
  • 45 Dean CM, Richards CL, Malouin F. Walking speed over 10 metres overestimates locomotor capacity after stroke. Clin Rehabil 2001; 15: 415-421
  • 46 Guyatt GH, Sullivan MJ, Thompson PJ. et al. The 6-minute walk: A new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J 1985; 132: 919-923
  • 47 Berg KO, Maki BE, Williams JI. et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil 1992; 73: 1073-1080
  • 48 Berg KO, Wood-Dauphinee SL, Williams JI. et al. Measuring balance in the elderly: Validation of an instrument. Can J Public Health 1992; 83 (Suppl. 02) S7-11
  • 49 Podsialo D, Richardson S. The timed „Up & Go”: A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142-148
  • 50 Mathias S, Nayak US, Isaacs B. Balance in elderly patients: The „get-up and go” test. Arch Phys Med Rehabil 1986; 67: 387-389
  • 51 Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000; 80: 896-903
  • 52 Carr J, Shepherd R. Stroke Rehabilitation: Guidelines for exercises and training. Elsevier Group; 2003
  • 53 Collen FM, Wade DT, Robb GF. et al. The Rivermead Mobility Index: A further development of the Rivermead Motor Assessment. Int Disabil Stud 1991; 13: 50-54
  • 54 Carr JH, Shepherd RB, Nordholm L. et al. Investigation of a new motor assessment scale for stroke patients. Phys Ther 1985; 65: 175-180
  • 55 Poole JL, Whitney SL. Motor assessment scale for stroke patients: Concurrent validity and interrater reliability. Arch Phys Med Rehabil 1988; 69: 195-197
  • 56 Meijer R, Ihnenfeldt DS, de Groot IJ. et al. Prognostic factors for ambulation and activities of daily living in the subacute phase after stroke: A systematic review of the literature. Clin Rehabil 2003; 17: 119-129 DOI: 10.1191/0269215503cr585oa.
  • 57 Veerbeek JM, Van Wegen EE, Harmeling-Van der Wel BC. et al. Is accurate prediction of gait in nonambulatory stroke patients possible within 72 hours poststroke? The EPOS study. Neurorehabil Neural Repair 2011; 25: 268-274 DOI: 10.1177/1545968310384271.
  • 58 Bijleveld-Uitman M, van de Port I, Kwakkel G. Is gait speed or walking distance a better predictor for community walking after stroke?. Journal of Rehabilitation Medicine 2013; 45: 535-540 DOI: 10.2340/16501977-1147.
  • 59 Durcan S, Flavin E, Horgan F. Factors associated with community ambulation in chronic stroke. Disabil Rehabil 2016; 38: 245-249 DOI: 10.3109/09638288.2015.1035460.
  • 60 Elbers RG, van Wegen EE, Verhoef J. et al. Is gait speed a valid measure to predict community ambulation in patients with Parkinson’s disease?. Journal of Rehabilitation Medicine 2013; 45: 370-375 DOI: 10.2340/16501977-1123.
  • 61 das Nair R, Moreton BJ, Lincoln NB. Rasch analysis of the Nottingham extended activities of daily living scale. Journal of Rehabilitation Medicine 2011; 43: 944-950 DOI: 10.2340/16501977-0858.
  • 62 Wu CY, Chuang LL, Lin KC. et al. Responsiveness, minimal detectable change, and minimal clinically important difference of the Nottingham Extended Activities of Daily Living Scale in patients with improved performance after stroke rehabilitation. Arch Phys Med Rehabil 2011; 92: 1281-1287 DOI: 10.1016/j.apmr.2011.03.008.
  • 63 Handlery R, Regan EW, Stewart JC. et al. Predictors of daily steps at 1-year poststroke: A secondary analysis of a randomized controlled trial. Stroke 2021; 52: 1768-1777 DOI: 10.1161/STROKEAHA.121.034249.
  • 64 Kawajiri H, Mishina H, Asano S. et al. Maximum walking speed at discharge could be a prognostic factor for vascular events in patients with mild stroke: A cohort study. Arch Phys Med Rehabil 2019; 100: 230-238 DOI: 10.1016/j.apmr.2018.05.025.
  • 65 Khanittanuphong P, Tipchatyotin S. Correlation of the gait speed with the quality of life and the quality of life classified according to speed-based community ambulation in Thai stroke survivors. NeuroRehabilitation 2017; 41: 135-141 DOI: 10.3233/NRE-171465.
  • 66 Louie DR, Eng JJ. Berg Balance Scale score at admission can predict walking suitable for community ambulation at discharge from inpatient stroke rehabilitation. Journal of Rehabilitation Medicine 2018; 50: 37-44 DOI: 10.2340/16501977-2280.
  • 67 Minor M, Jaywant A, Toglia J. et al. Discharge rehabilitation measures predict activity limitations in patients with stroke six months after inpatient rehabilitation. Am J Phys Med Rehabil. 2021 DOI: 10.1097/PHM.0000000000001908
  • 68 Mulder M, Nijland RH, van de Port IG. et al. Prospectively classifying community walkers after stroke: Who are they?. Arch Phys Med Rehabil 2019; 100: 2113-2118 DOI: 10.1016/j.apmr.2019.04.017.
  • 69 Outermans J, van de Port I, Wittink H. et al. How strongly is aerobic capacity correlated with walking speed and distance after stroke? Systematic review and meta-analysis. Phys Ther 2015; 95: 835-853 DOI: 10.2522/ptj.20140081.