Repeatability and Temporal Consistency of Lower Limb Biomechanical Variables Expressing Interlimb Coordination during the Double-Support Phase in People with and without Stroke Sequelae

Abstract

Reliable biomechanical methods to assess interlimb coordination during the double-support phase in post-stroke subjects are needed for assessing movement dysfunction and related variability. The data obtained could provide a significant contribution for designing rehabilitation programs and for their monitorisation. The present study aimed to determine the minimum number of gait cycles needed to obtain adequate values of repeatability and temporal consistency of lower limb kinematic, kinetic, and electromyographic parameters during the double support of walking in people with and without stroke sequelae. Eleven post-stroke and thirteen healthy participants performed 20 gait trials at self-selected speed in two separate moments with an interval between 72 h and 7 days. The joint position, the external mechanical work on the centre of mass, and the surface electromyographic activity of the tibialis anterior, soleus, gastrocnemius medialis, rectus femoris, vastus medialis, biceps femoris, and gluteus maximus muscles were extracted for analysis. Both the contralesional and ipsilesional and dominant and non-dominant limbs of participants with and without stroke sequelae, respectively, were evaluated either in trailing or leading positions. The intraclass correlation coefficient was used for assessing intra-session and inter-session consistency analysis. For most of the kinematic and the kinetic variables studied in each session, two to three trials were required for both groups, limbs, and positions. The electromyographic variables presented higher variability, requiring, therefore, a number of trials ranging from 2 to >10. Globally, the number of trials required inter-session ranged from 1 to >10 for kinematic, from 1 to 9 for kinetic, and 1 to >10 for electromyographic variables. Thus, for the double support analysis, three gait trials were required in order to assess the kinematic and kinetic variables in cross-sectional studies, while for longitudinal studies, a higher number of trials (>10) were required for kinematic, kinetic, and electromyographic variables.

Reliability of Obstacle-Crossing Parameters during Overground Walking in Young Adults

“…Contrary to us, the study from Punt et al (2017) assessed virtual obstacle-crossing task during treadmill walking in stroke survivors [ 64 ], while Grinberg et al (2021) did not assess obstacle-crossing parameters during overground walking [ 66 ], and Said et al (2009) did not involve young healthy adults [ 65 ]. In addition, the sample size of the present study is relatively high (n = 43), compared to previously conducted gait reliability studies [ 1 , 2 , 3 , 5 , 8 , 11 , 38 ]. At this point, it is important to mention that, fully in line with the scientific roadmap we have set up to assess the intra-session reliability of the 10 m walk test [ 2 ], we focused on young healthy adults as a first step to provide normative reference values for a young healthy population (e.g., see [ 67 , 68 , 69 ]).…”

“…Indeed, if gait analysis is intended to serve as an outcome measure for diagnostic, monitoring, or therapeutic purposes, the level of reliability for each computed gait parameter has to be established. This is certainly one of the reasons that has prompted scientists and researchers to focus on the reliability assessment of gait measurements in both healthy [1][2][3][4][5] and pathological [3,[6][7][8][9][10][11] populations. In previous studies conducted on overground/flat conditions in healthy patients [2] and stroke individuals [6,7], speed and stride length [2,6,7], as well as cadence and gait cycle time [7], showed good reliability.…”

“…This is certainly one of the reasons that has prompted scientists and researchers to focus on the reliability assessment of gait measurements in both healthy [ 1 , 2 , 3 , 4 , 5 ] and pathological [ 3 , 6 , 7 , 8 , 9 , 10 , 11 ] populations. In previous studies conducted on overground/flat conditions in healthy patients [ 2 ] and stroke individuals [ 6 , 7 ], speed and stride length [ 2 , 6 , 7 ], as well as cadence and gait cycle time [ 7 ], showed good reliability.…”