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Stroke Research and Treatment
Volume 2014, Article ID 646230, 6 pages
Research Article

Do Improvements in Balance Relate to Improvements in Long-Distance Walking Function after Stroke?

1Department of Physical Therapy, University of Delaware, 540 South College Avenue, Newark, DE 19713, USA
2Graduate Program in Biomechanics and Movement Science, Newark, DE 19713, USA
3Delaware Clinical and Translational Research Accel Program, Newark, DE 19713, USA

Received 24 March 2014; Revised 4 June 2014; Accepted 8 June 2014; Published 10 July 2014

Academic Editor: Steve Kautz

Copyright © 2014 Louis N. Awad et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Stroke survivors identify a reduced capacity to walk farther distances as a factor limiting their engagement at home and in community. Previous observational studies have shown that measures of balance ability and balance self-efficacy are strong predictors of long-distance walking function after stroke. Consequently, recommendations to target balance during rehabilitation have been put forth. The purpose of this study was to determine if the changes in balance and long-distance walking function observed following a 12-week poststroke walking rehabilitation program were related. For thirty-one subjects with hemiparesis after stroke, this investigation explored the cross-sectional (i.e., before training) and longitudinal (i.e., changes due to intervention) relationships between measures of standing balance, walking balance, and balance self-efficacy versus long-distance walking function as measured via the 6-minute walk test (6MWT). A regression model containing all three balance variables accounted for 60.8% of the variance in 6MWT performance (; ; ); however, only dynamic balance (FGA) was an independent predictor () of 6MWT distance. Interestingly, changes in balance were unrelated to changes in the distance walked (each correlation coefficient , ). For persons after stroke similar to those studied, improving balance may not be sufficient to improve long-distance walking function.