Reasons for failure in gait rehabilitation after stroke hip fracture and lower limb amputation

During a period of 12 months, 136 patients were discharged from the rehabilitation unit into the community. This article retrospectively reviewed the discharge letter in the medical dossiers for these cases. The patient group included: seventy-one patients recovering after a first stroke and 75 after a recurrent stroke, 13 cases were operated after traumatic hip fracture, 15 were after below-knee amputation and one, after above-knee amputation. Eleven patients had other diseases or injuries. Patients were considered ambulators if they were able to walk independently, with or without assisting device, inside the department for a distance of at least 5 meters. Nonambulating patients could not walk or could walk only a few steps with full assistance, for a distance of less than 5 meters. Only 9 patients remained wheelchair dependents at the end of the rehabilitation period (6 after stroke, one after hip fracture and 2 amputees). The 6 stroke patients were all unable to support their body weight over the hypotonic paralyzed leg or to balance between the leg and the walking device. The only patient in this subgroup after hip fracture suffered from hemiplegia, contralateral previously operated hip fracture and Parkinson disease. Among the two amputees, one refused to continue the rehabilitation program and the other, suffered from motor and cognitive disorders following three episodes of stroke.