Postural Maintenance Is Associated with Walking Ability in People Receiving Acute Rehabilitation after a Stroke

Abstract

Abstract Objectives The Postural Assessment Scale for Stroke Patients (PASS) assesses the ability of people poststroke to maintain or change a given posture from lying to standing, and the items on which people with different walking status perform differently may suggest potential interventions. The purpose of this study was to (1) examine the association of PASS scores at admission for acute rehabilitation with walking status at admission and 3 months poststroke and (2) identify PASS items that discriminate walking status. Methods In this prospective observational study, 93 people poststroke were assessed with the PASS and a 2.44-m gait speed test at admission, with walking status assessed by telephone interview at 3 months poststroke. Those who could walk over a 2.44-m distance without the assistance of a walking aid or another person were considered to be independent in walking; others were considered to be dependent. Those who were dependent at admission were divided into the “regained independence” and “remained dependent” groups based on their status at 3 months poststroke. The association of the PASS at admission with 3 levels of walking status (independent at admission, regained independence, and remained dependent) was examined using the Kruskal-Wallis test. For those dependent at admission, the association of PASS score at admission with walking status at 3 months poststroke was examined using logistic regression and receiver operating curve analysis. Results PASS scores at admission differed significantly across the 3 walking status groups and were significantly associated with walking status at 3 months poststroke (odds ratio = 0.864; 95% CI = 0.798–0.935) over and above length of stay. People poststroke who were dependent at admission and had PASS scores of ≥22 were more likely to regain independence at 3 months poststroke. Nine PASS items differed among the 3 groups. Conclusions PASS score is significantly associated with walking status at admission and at 3 months poststroke. The identified 9 items suggest possible interventions for acute rehabilitation. Impact This study identified 9 PASS items that could guide clinicians in selecting interventions for acute rehabilitation.