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Abstract WMP86: Novel, High-tech Walking Recovery Program Improves Motor Recovery


 Introduction:
 Although there are a number of research studies investigating walking recovery after stroke, most focus on one intervention or piece of equipment in order to achieve a controlled experimental environment. Such studies have yet to produce a comprehensive clinical practice guideline (CPG) for gait training. To fill this void, we implemented a clinical program for walking recovery, iWalk™, using a variety of advanced technologies, and an evidence-based CPG to assist in making assessment and intervention decisions. This study compares outcomes of patients treated using a traditional therapy program to those treated with the iWalk program.
 
 
 Hypothesis:
 The systematic application of a novel, evidence-based CPG for walking recovery will result in superior motor performance when compared to traditional therapy in patients post stroke.
 
 
 Methods:
 This study included all stroke survivors admitted to a rehab facility during a 24 month period, with the cohort split into two groups. The control group received traditional rehabilitation (n=152) and the experimental group received the iWalk protocol (n=165). Since full implementation of the protocol could not be assigned a specific date, a buffer group (n=50) between the two groups was excluded from this analysis.
 
 
 Results:
 Functional Independence Measure: An interaction between age and treatment program was detected (p<0.001). Motor FIM scores showed greater improvement for younger patients in iWalk than in the traditional therapy program.
 
 
 Length of Stay:
 When examining LOS as an outcome, an interaction between treatment group and total FIM score was detected (p=0.073). Patients who were lower functioning on admission were more likely to be discharged home if they were in the iWalk program. Examining LOS as a predictor, the difference in timed-up-and-go scores between the treatment groups reveals that iWalk seems to be better for a LOS around 3 weeks, but is not significant (p>0.05).
 
 
 Conclusions:
 This study demonstrates outcome differences that favor iWalk. Additionally, there may be a LOS range which optimizes motor recovery. It is unclear whether a patient’s LOS is a reflection of the improvement of clinical variables or practical reasons. Further work is necessary on this topic.
