Changes in gait symmetry and velocity after stroke: a cross-sectional study from weeks to years after stroke

• Published in: Neurorehabilitation and neural repair Vol. 24; no. 9; p. 783
• Main Authors: Patterson, Kara K, Gage, William H, Brooks, Dina, Black, Sandra E, McIlroy, William E
• Format: Journal Article
• Language: English
• Published: United States 01.11.2010
• Subjects: Aged; Cross-Sectional Studies; Disability Evaluation; Female; Gait - physiology; Gait Disorders, Neurologic - complications; Gait Disorders, Neurologic - physiopathology; Gait Disorders, Neurologic - rehabilitation; Humans; Leg - innervation; Leg - physiopathology; Linear Models; Male; Middle Aged; Mobility Limitation; Stroke - complications; Stroke - physiopathology; Stroke Rehabilitation; Time Factors; Walking - physiology
• ISSN: 1552-6844
• DOI: 10.1177/1545968310372091

There is little information about the quality of gait in the years following stroke. Long-term changes in mobility, using global indices of function, suggest a decline well after initial rehabilitation. However, global indices of mobility do not reveal more specific changes in walking competency or underlying gait-specific impairment. The authors used a cross-sectional design with gait-specific measures (velocity and symmetry) to investigate whether deterioration in gait occurs over the long term poststroke. Data were abstracted from a standardized database containing clinical assessments and spatiotemporal gait analyses for 171 individuals with stroke. Velocity and 3 expressions of symmetry ratios (swing time, stance time, and step length) were calculated for each individual; they were then assigned to 1 of the 5 following groups: 0 to 3, 3 to 12, 12 to 24, 24 to 48, and >48 months poststroke. Swing time, stance time, and step length symmetry demonstrated a systematic linear trend toward greater asymmetry in groups in the later stages poststroke, whereas velocity, neurological deficit, and lower-extremity (LE) motor impairment did not. The quality of gait, as measured by spatial and temporal symmetry, appears to worsen in later years. These results suggest a dissociation between quantitative measures of gait, such as velocity versus symmetry, and that these parameters may measure independent features. A longitudinal study is needed to confirm the presence and to interpret the clinical meaning of a long-term decline in specific parameters of poststroke gait.