Predictors of gait in post-stroke patients: the potential of PASS and TCT as predictors of walking after stroke – A prospective longitudinal observational study

Ferreira, Mariana Barbas

http://hdl.handle.net/10400.21/21477

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Authors

Ferreira, Mariana Barbas

Advisor(s)

Fernandes, Beatriz

Abstract(s)

Background and Purpose: Early prognosis and goal setting are important for stroke management. Independent gait is a key rehabilitation goal. This study evaluates whether the Postural Assessment Stroke Scale (PASS) and Trunk Control Test (TCT), measured 5 days post-stroke, can predict independent walking (Functional Ambulation Categories (FAC) at 3 months. It also aims to establish optimal cut-off values for predicting independent gait in a hospital stroke care context. Methods: This prospective longitudinal observational study included 42 post-stroke patients who completed a 3-month follow-up. Demographic and clinical data and postural control scores (PASS and TCT) were collected at 5 days post-stroke. Patients were classified as independent walkers (FAC ≥ 4) or dependent walkers (FAC < 4). Univariate and multivariate logistic regression analyses were performed to identify significant predictors. Receiver Operating Characteristics (ROC) curve analysis determined predictive accuracy and optimal cut-off scores. Results: Of the 42 patients, 64,3% (n=27) achieved independent gait at 3 months. The PASS on day five was the only significant predictor of independent walking (odds ratio = 0.903, 95% CI: 0.832–0.982). The area under the ROC (AUC) for PASS was 0.746 (95% CI: 0.587–0.904). The optimal PASS cut-off score for predicting independent gait was 13,50, with 81,5% sensitivity and 33,3% specificity. Conclusions: The PASS score on day 5 post-stroke significantly predicts independent walking at 3 months. A PASS score ≥ 13.5 indicates a high likelihood of achieving independent gait. Each additional PASS point increases the odds of independent walking by 9.7%, providing valuable insights for clinical decision-making and discharge planning.

Description

Mestrado em Fisioterapia - Área de especialização: Fisioterapia Neurológica

Keywords

Physiotherapy Rehabilitation Walking Postural control Predictors Stroke MFT

URI

http://hdl.handle.net/10400.21/21477

Citation

Ferreira MB. Predictors of gait in post-stroke patients: the potential of PASS and TCT as predictors of walking after stroke – A prospective longitudinal observational study [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2024.