Abstract 3137: Significant Impairment in Gait Coordination Consistency at Two Self-Selected Walking Speeds in Chronic Stroke
Background/Objectives: Gait coordination is not well-studied nor well-described in chronic stroke. Gait coordination can be defined as the simultaneous consideration of spatial and temporal movement characteristics. One aspect of gait coordination is the consistency of relative movements of hip/knee, hip/ankle, and knee/ankle across the gait cycle. Without consistency of relative joint movement from step to step, safety of gait is compromised and function is reduced. Therefore, the hypothesis of this study was that in chronic stroke survivors with persistent gait deficits, consistency of gait coordination is impaired, according to a measure of inter-joint coordination consistency (hip/knee; hip/ankle; and knee/ankle) of movement excursion and timing across the gait cycle from step to step.
Methods: Ten healthy adults and thirty-eight subjects with persistnet gait deficits were enrolled (>6mos after stroke). In terms of gait speed, stroke subjects were either household ambulators (HA; <.4m/s; n=28) or limited community ambulators (CA; .41-.9m/s; n=10). Control subjects’ gait variables were measured at each of these two speeds imposed during testing. Gait kinematics were measure using Vicon MX (Oxford Metrics, UK) and modified Helen Hayes model of marker placement. The average consistency coefficient (ACC, range 0 - 1) was calculated for hip/knee (H/K ACC), hip/ankle (H/A ACC), and knee/ankle (K/A AC) for both controls and stroke. ACC=1, indicated perfect consistency from step-to-step in terms of relative inter-limb joint movement. T-test was employed to compare stroke versus controls for each coordination consistency measure. Findings: Within the HA-speed group, there was a significant difference between stroke and HA-speed controls in terms of H/K ACC, H/A ACC, and K/A ACC (p = .0001). Also within the CA-speed group, there was a significant difference between stroke and CA-speed controls for all three measures of coordination consistency (p=.0001). Control subject ACC’s ranged from .85 - .95; whereas, stroke ACC’s ranged from .7063 - .8638 (1=perfect consistency).
Conclusions: Inconsistent relative joint movement between hip, knee, and ankle across the gait cycle, could be a source of falls, poor walking endurance, and dysfunction. The presence of this impairment should be noted in assessment and targeted during treatment.
- © 2012 by American Heart Association, Inc.