Abstract
Objective
To describe gait characteristics of patients without clinical evidence of lower limb
hypertonia within 2 months of stroke and explore the relationship between gait and
residual motor function.
Design
Cohort study.
Setting
Motion analysis laboratory in a tertiary-care free-standing rehabilitation hospital.
Participants
Consecutive sample of 73 eligible inpatients (first-known stroke <2 months postonset,
walking independently, modified Ashworth score of 0 in the paretic lower limb) and
27 healthy controls (N=100).
Interventions
Not applicable.
Main Outcome Measures
Gait speed, stride and step lengths and cadences, stance time, single-support and
double-support times, and associated symmetry measures in patients at self-selected
normal speed and controls at very slow speed (51.1±32.6 cm/s and 61.9±21.8 cm/s, respectively,
P=.115); Fugl-Meyer lower extremity motor score (FM-LE) and isometric knee flexion
and extension strength in patients.
Results
Except the stride/step cadence, all temporospatial parameters significantly differed
between the stroke and control participants. Furthermore, significantly greater asymmetries
were found in the patients for the overall stance time, initial double-support and
single-support times, and step cadence, reflecting smaller values in the paretic than
nonparetic limb. Most temporospatial parameters moderately to strongly correlated
with the gait speed (|r|: .72-.94, P<.0001), FM-LE (|r|: .42-.62, P≤.0005), and paretic knee flexor strength (|r|: .47-.57, P≤.0004).
Conclusions
Gait of patients without clinical evidence of lower limb hypertonia within 2 months
of stroke is characterized by many temporospatial deviations and asymmetries. The
self-selected normal gait speed, FM-LE, and paretic knee flexor strength can discriminate
gait impairments in these patients shortly before inpatient discharge. It remains
to be determined whether the observed relationships between paretic knee flexor strength
and gait measures warrant the development of interventions for strengthening of the
paretic knee flexors in order to improve gait early poststroke.
Keywords
List of abbreviations:
FM-LE (Fugl-Meyer lower extremity motor score), SI (symmetry index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 14, 2018
Footnotes
Supported in part by the Wilson Research Foundation, Jackson, MS, and the H.F. McCarty, Jr. Family Foundation Fund for Stroke Research.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
