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

References 

  1. Bohannon RW, Andrews AW, Smith MB. Rehabilitation goals of patients with hemiplegia. Int J Rehabil Res. 1988;11:181–183
  2. Flansbjer U-B, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005;37:75–82
  3. Macko RF, Ivey FM, Forrester LW, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke (A randomized, controlled trial). Stroke. 2005;36:2206–2211
  4. Mizrahi J, Susak Z, Heller I, Najenson T. Variation of time-distance parameters of the stride as related to clinical gait improvement in hemiplegics. Scand J Rehabil Med. 1982;14:133–140
  5. Lord SE, Halligan PW, Wade DT. Visual gait analysis: the development of a clinical assessment and scale. Clin Rehabil. 1998;12:107–119
  6. Olney SJ, Griffin MP, McBride ID. Temporal, kinematic and kinetic variables related to gait speed in subjects with hemiplegia: a regression approach. Phys Ther. 1994;74:872–885
  7. Kim CM, Eng JJ. Symmetry in vertical ground reaction force is accompanied by symmetry in temporal but not distance variables of gait in persons with stroke. Gait Posture. 2003;18:23–28
  8. Bohannon RW. Gait performance of hemiparetic stroke patients: selected variables. Arch Phys Med Rehabil. 1987;68:777–781
  9. Brandstater ME, deBruin H, Gowland C, Clarke BM. Hemiplegic gait: analysis of temporal variables. Arch Phys Med Rehabil. 1983;64:583–587
  10. Wall JC, Turnbull GI. Gait asymmetries in residual hemiplegia. Arch Phys Med Rehabil. 1986;67:550–553
  11. Griffin MP, Olney SJ, McBride ID. Role of symmetry in gait performance of stroke subjects with hemiplegia. Gait Posture. 1995;3:132–142
  12. Roth EJ, Merbitz C, Mroczek K, Dugan SA, Suh WW. Hemiplegic gait: relationships between walking speed and other temporal parameters. Am J Phys Med Rehabil. 1997;76:128–133
  13. Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84:1185–1193
  14. Davis BL, Ortolano M, Richards K, Redhed J, Kuznicki J, Sahgal V. Realtime visual feedback diminishes energy consumption of amputee subjects during treadmill locomotion. J Prosthet Orthot. 2004;16:49–54
  15. Draper ER. A treadmill-based system for measuring symmetry of gait. Med Eng Phys. 2000;22:215–222
  16. Platts MM, Rafferty D, Paul L. Metabolic cost of overground gait in younger stroke patients and healthy controls. Med Sci Sports Exerc. 2006;38:1041–1046
  17. Michael KM, Allen JK, Macko RF. Reduced ambulatory activity after stroke: the role of balance, gait and cardiovascular fitness. Arch Phys Med Rehabil. 2005;86:1552–1556
  18. Nolan L, Wit A, Dudzinski K, Lees A, Lake M, Wychowanski M. Adjustments in gait symmetry with walking speed in trans-femoral and trans-tibial amputees. Gait Posture. 2003;17:142–151
  19. Norvell DC, Czerniecki JM, Reiber GE, Maynard C, Pecoraro JA, Weiss NS. The prevalence of knee pain and symptomatic knee osteoarthritis among veteran traumatic amputees and nonamputees. Arch Phys Med Rehabil. 2005;86:487–493
  20. Chen G, Patten C, Kothari DH, Zajac FE. Gait differences between individuals with post-stroke hemiparesis and non-disabled controls at matched speeds. Gait Posture. 2005;22:51–56
  21. Lin P, Yang Y, Cheng S, Wang R. The relation between ankle impairments and gait velocity and symmetry in people with stroke. Arch Phys Med Rehabil. 2006;87:562–568
  22. Gowland C, VanHullenaar S, Torresin W. Chedoke-McMaster Stroke Assessment: development, validation and administration manual. Hamilton: McMaster Univ; 1995;
  23. Gowland C, Stratford P, Ward M, et al. Measuring physical impairment and disability with the Chedoke-McMaster stroke assessment. Stroke. 1993;24:58–63
  24. Cohen E. Gait asymmetry and step to step variability post stroke. [dissertation] Toronto: Univ Toronto; 2004;
  25. Patterson KK. Characteristics of independent ambulation in chronic stroke survivors. [dissertation] Toronto: Univ Toronto; 2006;
  26. Holden MK, Gill KM, Magliozzi MR. Gait assessment for neurologically impaired patients (Standards for outcome assessment). Phys Ther. 1986;66:1530–1539
  27. Perry J, Garrett M, Gronley JK, Mulroy SJ. Classification of walking handicap in the stroke population. Stroke. 1995;26:982–989
  28. Taylor D, Stretton CM, Mudge S, Garrett N. Does clinic-measured gait speed differ from gait speed measured in the community in people with stroke?. Clin Rehabil. 2006;20:438–444

 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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