Gait speed at the acute phase predicted health-related quality of life at 3 and 12 months after stroke: a prospective cohort study

Abstract

Objective: To investigate the association between acute-phase gait speed and health-related quality of life (HRQoL) at 3 and 12 months post-stroke. Design: Prospective cohort study. Subjects/Patients: 1,475 patients with first-ever ischaemic stroke. Methods: The patients were divided into 3 groups according to tertiles of gait speed, namely ≤0.8, 0.8–1.1, ≥1.1 m/s. Gait speed was assessed by the 10-m walking test within 2 weeks of hospitalization for acute stroke and before the rehabilitation programme. HRQoL measurements include the 3-level EuroQol five dimensions (EQ-5D-3L) index and EuroQoL visual analogue scale (EQ-VAS) scores. Linear and logistic regression analyses were used to identify associations between gait speed and HRQoL. Results: Adjusted for all covariates, the highest gait speed tertile group were associated with higher EQ-5D-3L index (B = 0.0303 and B = 0.0228, respectively, p < 0.001), and higher EQ-VAS (B = 3.3038 and B = 3.8877, respectively, p < 0.001), and lower odds of having problems with mobility (OR = 2.55 [95% CI: 0.141–0.458] and 0.485 [0.289–0.812], respectively, p < 0.01), self-care (OR = 0.328 [95% CI: 0.167–0.646] and 0.412 [0.217–0.784], respectively, p < 0.01), and usual activities (OR = 0.353 [95% CI: 0.211–0.590] and 0.325 [0.198–0.536], respectively, p < 0.0001) at 3 and 12 months, and pain/discomfort at 12 months (OR = 0.558 [95% CI:0.335–0.930], p < 0.05). Conclusion: Acute-phase gait speed was predictive of post-stroke HRQoL at 3 and 12 months, especially when associated with domain-specific EQ-5D-3L.