White matter hyperintensity predicts independent walking function at 6 months after stroke: A retrospective cohort study

BACKGROUND: White matter hyperintensity (WMH) is reported to have a potential prevalence in healthy people and is a predictor of walking disability. However, WMH has not been adequately considered as a predictor of independent walking after stroke. OBJECTIVE: To investigate the effects of WMH severity on walking function in patients with acute stroke. METHODS: The retrospective cohort study included 422 patients with acute stroke. The WMH severity from magnetic resonance images was evaluated using the Fazekas scale. Age, type of stroke, Fazekas scale, Brunnstrom motor recovery stage, Motricity Index, and Mini-Mental State Examination were used as independent variables. Multivariable logistic regression analysis was conducted on the factors of independent walking at discharge and 6 months after onset, respectively. RESULTS: Multivariable analysis revealed that the Fazekas scale is not a predictive factor of independent walking at discharge (odds ratio [OR] = 0.89, 95% confidence intervals [CI] = 0.65–1.22), but at 6 months (OR = 0.54, 95% CI = 0.34–0.86). CONCLUSION: The WMH severity was a predictive factor of independent walking in patients with acute stroke after 6 months. WMH is a factor that should be considered to improve the accuracy of predicting long-term walking function in patients with stroke.