TITLE:
Factors Associated with the Walking Ability of Hemiplegic Stroke Patients
AUTHORS:
Akira Matsuyama
KEYWORDS:
Stroke, Gait, Paralysis, Muscle, Spirituality
JOURNAL NAME:
Open Journal of Nursing,
Vol.8 No.1,
January
24,
2018
ABSTRACT: Gait disturbance due to motor paralysis affects
activities of daily living and quality of life in patients with stroke. Thus,
commencing walking training from the acute phase of recovery is essential. This study aimed to clarify the factors affecting the walking ability of hemiplegic stroke patients. Eighty hospitalized
patients with a first chemic or hemorrhagic
stroke within 1 year but not less than 1 month after stroke onset were included
in this study. The dependent variable was walking ability (Functional
Independence Measure [FIM] locomotion score), and the independent variables were spirituality (Spirituality Rating Scale-A [SRS-A]), amount of social support (Japanese
version of the Abbreviated Multidimensional Scale of Perceived Social Support,
frequency of family visit), stroke severity (National Institutes of Health Stroke Scale [NIHSS]), degree of
motor paralysis (lower extremity Brunnstrom stage), the
lower limb loading force of the affected and unaffected side, and age.
Spearman’s rank correlation coefficient and multiple regression analysis were
performed. Multiple regression analysis showed that FIM locomotion score was associated
with NIHSS (standard partial regression coefficient = ?0.362, P 0.001), the unaffected lower limb loading force (standard partial
regression coefficient = 0.264, P 0.001), lower extremity Brunnstrom stage (standard partial regression
coefficient = 0.352, P 0.001), and SRS-A (standard partial regression coefficient = 0.184, P 0.011). From our findings, walking ability was affected by stroke severity and
the degree of paralysis, the unaffected lower limb loading force, and the
spirituality level in patients with stroke. Promoting walking ability in
patients with stroke includes training the unaffected lower limb and
heightening spirituality. Training of the unaffected lower limb should be
performed at the bedside or on the bed by the patient or a bedside nurse. To
heighten spirituality, nurses who care for patients with stroke are encouraged
to practice active listening and to show sympathy as part of emotional support
and spiritual care.