Relationships between gait variability and ambulatory activity post stroke

Abstract

Background: Fall risk and balance confidence are related to gait variability and ambulatory activity post-stroke, yet whether a relationship exists between gait variability and ambulatory activity is unknown. Knowing if gait variability measured under naturalistic conditions is related to ambulatory activity could explain more about the relationship between falls and walking activity post-stroke. Objectives: To examine relationships between spontaneous, daily ambulatory activity and gait variability during single-and dual-task walking, in low-and high-distraction settings in adults post-stroke. Methods: Sixteen community-dwelling adults post-stroke participated in a cross-sectional study. Spatiotemporal gait parameters were recorded during single-and cognitive-motor dual-task walking in low-and high-distraction settings. Coefficient of variation was calculated for stride length and stride duration. Average walking bout duration, maximum walking bout duration, and total number of steps per day were captured using an activity monitor. Correlations between ambulatory activity measures and gait variability were examined. Results: In the high-distraction setting, single-task stride duration variability was negatively related to all three ambulatory activity measures, but the strongest relationship was a negative correlation between dual-task stride duration variability and average walking duration. In the lowdistraction setting, single-task stride duration variability was negatively related to maximum walking duration. None of the other variability measures were related to ambulatory activity. Conclusions: The finding that stride duration variability in a high-distraction environment, with or without an additional cognitive task, is related to ambulatory activity in community-dwelling stroke survivors suggests that assessments incorporating attentional demands of real-world walking may be useful additions to clinical practice.

Increased temporal stride variability contributes to impaired gait coordination after stroke

“…The stroke group showed greater stride length variability and stride time variability suggesting heightened inconsistency in timing and distance between consecutive strides. These findings are in line with previous reports showing increased gait variability in spatial and temporal domains following stroke 11 , 41 . We found that both stride length variability and stride time variability were positively correlated to PCI in the stroke group (Table 2 ).…”

Dual-Task Abilities During Activities Representative of Daily Life in Community-Dwelling Stroke Survivors: A Pilot Study

“…Thus, it is currently difficult to estimate the impact of performing two tasks simultaneously on daily activities in stroke survivors. To improve the ecological validity of assessments, recent studies have explored DT abilities of stroke survivors in a real-life environment ( 19 , 20 ). Assessing DT abilities with a standardized and reproducible protocol in the community remains a challenge.…”

Estimation of Walking Speed and Its Spatiotemporal Determinants Using a Single Inertial Sensor Worn on the Thigh: From Healthy to Hemiparetic Walking

“…That is, regardless of how far they can walk during the 6 minute walk test, individuals who slow down during the test walk less in the community than more endurant individuals. Beyond long-distance walking speed, real-world community walking activity is also associated with step-to-step variability in the spatiotemporal determinants of walking speed (i.e., stride length and stride time); individuals with higher gait variability have lower balance confidence, increased fall rates, and less physical activity [5][6][7][8][9].…”