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. 1. Introduction The recovery of walking function is an ultimate goal of rehabilitation after stroke [1]. Indeed, for a majority of stroke survivors, impairments in their ability to walk farther limit their participation at home and in the community [2]. Unfortunately, current therapies are generally unable to improve the majority of subjects’ capacity for community ambulation [3]. Moreover, walking deficits that contribute to reduced endurance and speed persist following rehabilitation [4–6]. A better understanding of the changes underlying improvements in long-distance walking function following walking rehabilitation would inform future efforts and define specific targets for gait intervention. Recent observational studies have shown balance to be a powerful predictor of poststroke walking function [7–13] and a variable related to quality of life after stroke [14]. Specifically, individuals with better balance abilities typically present with better walking function. Based on such findings, recommendations to target balance during poststroke rehabilitation are commonly put forth. However, basing interventions on the results of cross-sectional studies may not be
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