The development of Ambulation Independence Measure: A new measurement tool to assess gait ability in acute stroke patients

BACKGROUND: The assessment of gait function is important for stroke rehabilitation. Gait function of patients with stroke often depends on the type of orthosis. There are however few gait assessments that assess the type of orthosis. OBJECTIVE: The purpose of this study was to investigate the reliability and validity of our newly developed Ambulation Independence Measure (AIM), which assesses the gait function, type of orthoses and physical assistance, for acute stroke patients. METHODS: A total of 73 acute stroke patients participated in this prospective study. The AIM discriminates 7 levels of gait ability on the basis of the amount of physical assistance required and orthoses that are used during walking. Interrater reliability, concurrent validity with the Functional Ambulation Category (FAC) and predictive validity were examined. RESULTS: The weighted kappas of AIM at the start of gait training (baseline) and discharge were 0.990 and 0.978, respectively. The AIM scores were significantly correlated with the FAC scores at both baseline (r = 0.808) and discharge (r = 0.934). Multiple regression analyses showed that the AIM at baseline was a stronger predictor of the FAC at discharge (R(2) = 0.80). CONCLUSIONS: The AIM has excellent reliability, concurrent validity, predictive validity, and good responsiveness in acute stroke patients.