Changes in Gait Symmetry and Velocity After Stroke: A Cross-Sectional Study From Weeks to Years After Stroke

Patterson, Kara K.; Gage, William H.; Brooks, Dina; Black, Sandra E.; McIlroy, William E.

doi:10.1177/1545968310372091

Cited by 163 publications

(131 citation statements)

References 34 publications

(48 reference statements)

Supporting

Mentioning

125

Contrasting

Unclassified

Order By: Relevance

Section: Spatial Asymmetrysupporting

confidence: 79%

“…The work of Patterson et al [38] supports this interpretation. Their study performed on 171 individuals post stroke concluded that spatial and temporal asymmetries were worse in the later stages post stroke, whereas neurological deficit and lower-extremity motor impairment (measured with the National Institutes of Health Stroke Scale and the Chedoke-McMaster Stroke Assessment) were not [38]. The same group of authors also showed that even patients with mild sensorimotor deficits could present considerable temporal asymmetries [15] and sensorimotor deficits could be observed with or without gait asymmetries.…”

Section: Spatial Asymmetrysupporting

confidence: 79%

“…Many studies have found a significant correlation between temporal asymmetry and walking speed (r ≥-0.54) [14,15,29,45,53,55,75] whereas others have found no significant relationship [39]. A point that emerges is that relation between walking speed and temporal asymmetry is not linear since individuals walking at slow speed show a more important association with temporal asymmetry (<0.6m/s) [14,15].…”

Section: Relation Between Spatiotemporal Asymmetry and Walking Speedmentioning

confidence: 92%

“…A point that emerges is that relation between walking speed and temporal asymmetry is not linear since individuals walking at slow speed show a more important association with temporal asymmetry (<0.6m/s) [14,15]. Relation between walking speed and step length asymmetry is generally low (r values ranging from -0.35 to -0.46) [14,54,75] or has not been found significant [15,45]. More studies are required to explain how spatiotemporal asymmetry influences gait speed or vice versa.…”

Section: Relation Between Spatiotemporal Asymmetry and Walking Speedmentioning

confidence: 99%

“…Temporal asymmetry: Studies reported that around 60% of individuals post stroke presented temporal asymmetry [14,15] with stance time [37][38][39], single stance time [40,41], double support time [14,29] and swing time [25,[38][39][40] being the parameters most often reported. A recent study quantified the correlations between asymmetry of different temporal gait parameters in 161 individuals post stroke [14].…”

Section: Spatiotemporal Asymmetries and Their Relationshipsmentioning

confidence: 99%

See 4 more Smart Citations

Understanding Spatial and Temporal Gait Asymmetries in Individuals Post Stroke

Lauzière¹,

Betschart²,

Aïssaoui³

et al. 2014

Int J Phys Med Rehabil

View full text Add to dashboard Cite

Gait asymmetry in spatial and temporal parameters and its impacts on functional activities have always raised many interesting questions in research and rehabilitation. The aim of this topical review is threefold: 1) to examine different equations of asymmetry of gait parameters and make recommendations for standardization, 2) to deepen the understanding of the relationships between sensorimotor deficits, spatiotemporal (step length, swing time and double support time) and biomechanical (kinematic, kinetic, muscular activity) parameter asymmetries during gait and, 3) to summarize the impacts of gait asymmetry on walking speed, falls, and energy cost in individuals post stroke. In light of current literature, we recommend quantifying spatiotemporal asymmetries by calculating symmetry ratios. However, for other gait parameters (such as kinetic or kinematic data), the choice will depend on the variability of the data and the objective of the study. Regardless of the selected asymmetry equation, we recommend presenting the asymmetry values in combination with the mean value of each side to facilitate comparisons between studies. This review also revealed that sensorimotor deficits clinically measured are not sufficient to explain the large variability of spatiotemporal asymmetries (particularly for step length and double support time) in individuals post stroke. Biomechanical analysis has been identified as a relevant approach to understanding gait deviations. Studies that linked biomechanical impairments to spatiotemporal asymmetries suggest that a balance issue and an impaired paretic forward propulsion could be among the important factors underlying spatiotemporal asymmetries. In our opinion, this paper provides meaningful information to aid in better understanding gait deviations in persons after stroke and establishes the need for future studies regrouping individuals post stroke according to their spatiotemporal asymmetries. Furthermore, further studies targeting efficacy of locomotor rehabilitation and the impacts of gait asymmetry on risk of falls and energy expenditure are needed.

show abstract

Section: Spatial Asymmetrysupporting

confidence: 79%

Section: Spatial Asymmetrysupporting

confidence: 79%

Section: Relation Between Spatiotemporal Asymmetry and Walking Speedmentioning

confidence: 92%

Section: Relation Between Spatiotemporal Asymmetry and Walking Speedmentioning

confidence: 99%

Section: Spatiotemporal Asymmetries and Their Relationshipsmentioning

confidence: 99%

See 3 more Smart Citations

Understanding Spatial and Temporal Gait Asymmetries in Individuals Post Stroke

Lauzière¹,

Betschart²,

Aïssaoui³

et al. 2014

Int J Phys Med Rehabil

View full text Add to dashboard Cite

show abstract

Activity Monitor Placed at the Nonparetic Ankle Is Accurate in Measuring Step Counts During Community Walking in Poststroke Individuals: A Validation Study

Duclos

Aguiar

Aïssaoui

et al. 2019

PM&R

View full text Add to dashboard Cite

Background Different environmental factors may affect the accuracy of step‐count activity monitors (AM). However, the validation conditions for AM accuracy largely differ from ecological environments. Objectives To assess and compare the accuracy of AM in counting steps among poststroke individuals: during different locomotor tasks, with AM placed at the nonparetic ankle or hip, and when walking in a laboratory or inside a mall. Design Validation study. Settings Laboratory and community settings. Participants Twenty persons with chronic hemiparesis, independent walkers. Methods First session: participants performed level walking (6‐minute walk test [6MWT]), ramps, and stairs in the laboratory with AM placed at the nonparetic ankle and hip. Second session: participants walked a mall circuit, including the three tasks, with AM placed at the nonparetic ankle. The sessions were video recorded. Main Outcome Measurements Absolute difference between the steps counted by AM and the steps viewed on the video recordings (errors, %); occurrence of errors greater than 10%. Results Median errors were similar for the 6MWT (0.86 [0.22, 7.70]%), ramps (2.17 [0.89, 9.61]%), and stairs (8.33 [2.65, 19.22]%) with AM at the ankle. Step‐count error was lower when AM was placed at the ankle (8.33 [2.65, 19.22]%) than at the hip (9.26 [3.25, 42.63]%, P = .03). The greatest errors were observed among the slowest participants (≤0.4 m/s) on ramps and stairs, whereas some faster participants (>1 m/s) experienced the greatest error during the 6MWT. Median error was slightly increased in the mall circuit (2.67 [0.61, 12.54]%) compared with the 6MWT (0.50 [0.24, 6.79]%, P = .04), with more participants showing errors >10% during the circuit (7 vs 2, P = .05). Conclusions Step counts are accurately measured with AM placed at the nonparetic ankle in laboratory and community settings. Accuracy can be altered by stairs and ramps among the slowest walkers and by prolonged walking tasks among faster walkers. Level of Evidence III.

show abstract

Improving Interlimb Coordination Following Stroke: How Can We Change How People Walk (and Why Should We)?

Vasudevan

Kirk

2014

Biosystems &Amp; Biorobotics

View full text Add to dashboard Cite

Abstract.A frequent and debilitating consequence of stroke is hemiparesis -a weakness on one side of the body -which contributes to asymmetric interlimb coordination during walking. Such asymmetries have been associated with decreased gait efficiency, which may prevent or limit the return to school, work, and the community. Here, we discuss several approaches to gait rehabilitation that have been shown to reduce interlimb coordination asymmetries post-stroke. We also present counterarguments and discuss whether retraining symmetry poststroke is optimal for achieving gains in functional mobility. Overall, while it is possible to alter interlimb coordination following stroke, it is still not entirely certain that we should.

show abstract

Changes in Gait Symmetry and Velocity After Stroke: A Cross-Sectional Study From Weeks to Years After Stroke

Cited by 163 publications

References 34 publications

Understanding Spatial and Temporal Gait Asymmetries in Individuals Post Stroke

Understanding Spatial and Temporal Gait Asymmetries in Individuals Post Stroke

Activity Monitor Placed at the Nonparetic Ankle Is Accurate in Measuring Step Counts During Community Walking in Poststroke Individuals: A Validation Study

Improving Interlimb Coordination Following Stroke: How Can We Change How People Walk (and Why Should We)?

Contact Info

Product

Resources

About