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Is gait speed or walking distance a better predictor for community walking after stroke?

OBJECTIVE
To determine if gait speed or walking distance is a better predictor for community walking after stroke.


METHODS
Data from the FIT-Stroke trial were used in a cross-sectional design. Community walking was measured with a self-administered questionnaire. The 5-m timed walk and the 6-min walk were used to assess gait speed and walking distance. With bivariate regression analyses the association between gait speed or walking distance and community walking was tested and possible confounders were identified. Discriminative properties of gait speed and walking distance for community walking were investigated by means of receiver operating characteristic (ROC) curves.


RESULTS
79% of 241 patients were classified as community walkers. Standing balance, fear of falling and time post-stroke were found to be significant confounders in the relationship between gait speed and community walking. No significant confounders were found for the association between walking distance and community walking. There was no significant difference between the area under the curve of the ROC curves of gait speed (0.86), walking distance (0.89) and gait speed adjusted for confounding (0.89).


CONCLUSION
Gait speed and walking distance are equally appropriate predictors for community walking after stroke, whereas the contribution of confounders is limited.