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

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. LAY ABSTRACT Walking ability is one of the main priorities of persons who have suffered a stroke and has a large impact on health-related quality of life. The 10-m walking test at a comfortable gait speed has been used extensively in measuring walking ability in the acute phase of stroke. Other studies have shown that stroke patients perceive lower health-related quality of life than the general population in the first years after stroke. Therefore, this study aimed to investigate the association between acute-phase gait speed and post-stroke health-related quality of life at 3 and 12 months. This study indicated that stroke patients with acute-phase low speed had worse health-related quality of life and higher risk of having problems with mobility, self-care, and usual activities at 3 and 12 months after stroke, and increased risk of pain/discomfort problems at 12 months. In terms of clinical implications, an initial focus on patients’ walking abilities may have a significant impact on health-related quality of life.