Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 2 , Pages 304-310, February 2008

Gait Asymmetry in Community-Ambulating Stroke Survivors

  • Kara K. Patterson, MSc

      Affiliations

    • Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
    • Toronto Rehabilitation Institute, Toronto, ON, Canada
    • Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada
    • ,
  • Iwona Parafianowicz

      Affiliations

    • Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
    • ,
  • Cynthia J. Danells, MSc

      Affiliations

    • Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
    • ,
  • Valerie Closson, MSc

      Affiliations

    • Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
    • ,
  • Mary C. Verrier, MHSc

      Affiliations

    • Toronto Rehabilitation Institute, Toronto, ON, Canada
    • Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada
    • Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
    • ,
  • W. Richard Staines, PhD

      Affiliations

    • Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
    • Toronto Rehabilitation Institute, Toronto, ON, Canada
    • Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
    • ,
  • Sandra E. Black, MD, PhD

      Affiliations

    • Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
    • Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada
    • ,
  • William E. McIlroy, PhD

      Affiliations

    • Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
    • Toronto Rehabilitation Institute, Toronto, ON, Canada
    • Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada
    • Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
    • Corresponding Author InformationReprint requests to William E. McIlroy, PhD, Faculty of Applied Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada

Abstract 

Patterson KK, Parafianowicz I, Danells CJ, Closson V, Verrier MC, Staines WR, Black SE, McIlroy WE. Gait asymmetry in community-ambulating stroke survivors.

Objectives

To determine the prevalence and severity of asymmetry among independently ambulating stroke survivors and to establish the association between velocity and asymmetry.

Design

Descriptive analysis.

Setting

Research gait laboratory in a Canadian hospital.

Participants

Community-dwelling, independently ambulating participants (N=54) with chronic stroke.

Interventions

Not applicable.

Main Outcome Measures

Overground gait velocity, symmetry ratios for temporal and spatial step parameters, and motor impairment of the foot and leg. Spatiotemporal parameters were collected with a pressure-sensitive mat. Motor impairment was measured clinically with the Chedoke-McMaster Stroke Assessment.

Results

Thirty (55.5%) participants showed statistically significant temporal asymmetry and 18 (33.3%) exhibited statistically significant spatial asymmetry. Preferred velocity was negatively associated with temporal asymmetry (r=−.583, df=52, P<.001) but not spatial asymmetry (r=−.146, df=52, P=.29). Temporal asymmetry was also associated with motor recovery of the leg (r=−.644, df=35, P<.001) and foot (r=−.628, df=35, P<.001).

Conclusions

The results of the current study illustrate that temporal asymmetry can be found in many independently ambulating stroke patients. The work highlights the need for a standard assessment of poststroke gait symmetry in light of the complex relationship with motor impairment and velocity.

Key Words: Cerebrovascular accident, Gait disorders, neurologic, Rehabilitation

 

 Supported by the Toronto Rehabilitation Institute, Marguerite Harland Smith Bursary, Lois Snelling Bursary, and the Canadian Institutes of Health Research (grant no. MOP62957).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(07)01649-8

doi:10.1016/j.apmr.2007.08.142

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 2 , Pages 304-310, February 2008

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