Increased temporal stride variability contributes to impaired gait coordination after stroke

Patel, Prakruti; Enzastiga, Diana; Casamento‐Moran, Agostina; Christou, Evangelos A.; Lodha, Neha

doi:10.1038/s41598-022-17017-1

Cited by 18 publications

(5 citation statements)

References 51 publications

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“…Recently, Patel et al [29] reported that both temporal and spatial gait variability correlated with inter-limb coordination of walking in PwS, signifying that not only intra-limb coordination is required for safe and stable walking. The observed relations in both reports should be further examined to test whether these relations are causal, because if this is the case, rehabilitation programs for PwS would benefit from adding intra- and inter-limb coordination training.…”

Section: Discussionmentioning

confidence: 99%

Increased Spatiotemporal Variability after Stroke is not Just the Outcome of Walking Velocity

Koren

Barzel²,

Shmuelof

et al. 2023

Preprint

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Background: Increased spatiotemporal gait variability is considered a clinical biomarker of ageing and pathology, and a predictor of future falls. Nevertheless, it is unclear whether the increased spatiotemporal variability observed in persons with stroke (PwS) is directly related to the pathology or simply reflects their choice of walking velocity. Research question: Does increased spatiotemporal gait variability directly relate to motor coordination deficits after stroke? Methods: Forty PwS and 20 healthy adults participated in this cross-sectional study. Participants performed the lower-extremity motor coordination test (LEMOCOT) on an electronic mat equipped with force sensors. Then, participants walked for 120 s over a computerized treadmill at their comfortable walking velocity. For the LEMOCOT we used the traditional score of in-target touch count and computed the absolute and variable error around the targets. For gait variability, we extracted the standard deviation of step time, step length, step velocity, and step width. Using a data-based approach, we generated a model of the relationship between velocity and variability and tested the correlations of the velocity-controlled values with the outcome measures from the LEMOCOT. Results: PwS demonstrated increased variability in step time, step length, and step velocity, as well as decreased variability in step width, in comparison to healthy adults, even after controlling for walking velocity. After controlling for walking velocity, we observed that for PwS the LEMOCOT score correlated with the variance in step time, and the variable error in the LEMOCOT correlated with the variance in step length, in step width, and in step velocity. No significant correlation with any of the velocity-controlled step parameters was found for the absolute error in the LEMOCOT. Significance: Decreased performance in the LEMOCOT was associated with increased spatiotemporal variability in PwS, regardless of their walking velocity. Our results demonstrate the connection between lower-extremity coordination impairments and deficits in gait function.

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Section: Discussionmentioning

confidence: 99%

Increased Spatiotemporal Variability after Stroke is not Just the Outcome of Walking Velocity

Koren

Barzel²,

Shmuelof

et al. 2023

Preprint

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“…However, we did not examine which of these factors improved. Furthermore, increased spatial and temporal gait variability in patients with stroke has been reported ( 15 ). Evaluation from this perspective, in addition to the percentage of gait acquisition, may lead to more accurate decisions.…”

Section: Discussionmentioning

confidence: 99%

Postural control exercise without using the upper limbs improves activities of daily living in patients with stroke

Kamijo

Furihata

Kimura

et al. 2023

Front. Rehabil. Sci.

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IntroductionStroke is one of the most common neurological disorders worldwide. Stroke survivors have restricted activities of daily living (ADL) and lower functional independence measures (FIM) after disease onset. Recovery of postural control abilities in patients with stroke is one of the most important therapeutic goals. In this study, we examined the differences in the FIM motor items between groups that performed postural control exercises with the upper limb and those that performed postural control exercises without the upper limb.MethodsThe medical records of patients with stroke admitted and discharged from the Recovery Rehabilitation Unit at Azumino Red Cross Hospital between 2016 and 2018 were reviewed. We retrospectively investigated the relationships between postural control exercises with or without upper limbs, FIM motor items at admission and discharge, and percentage of gait acquisition at discharge.Results and DiscussionAmong the thirteen FIM motor items, nine (bathing, dressing the upper body, dressing the lower body, toileting, transfers [bed, chair, and wheelchair], transfers [toilet], transfers [tub or shower], locomotion, and climbing of stairs) were significantly different between the two groups (those who performed postural control exercises with the upper limb and those who performed postural control exercises without the upper limb). Patients with stroke who performed postural control exercises without the upper limbs showed a higher percentage of gait acquisition. Touch contact during quiet standing reduces body sway and the associated fluctuations. However, continual practice of postural control with a small degree of body sway for a long period after a stroke would result in decreased pressure on the sole. This may hinder postural control relearning. Touch contact also reduces anticipatory postural adjustment, which may limit the improvement in balance ability during physical exercise. Postural control exercises without the upper limbs improve postural control ability and may be beneficial from a long-term perspective.

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“…This result in CA patients may be related to a deficit in lower limb coordination reflecting arrhythmic muscle contractions between flexors and extensors during gait. Otherwise, gait variability in post-stroke individuals was found to be augmented in stride time, which contributes to the incoordination since it directly involves the accuracy and the consistency of gait coordination [57]. In a similar way, TBI patients tend to show an increased step time variability, which is strongly correlated with dynamic instability, which further increases when the gait task becomes more challenging [58].…”

Section: Clinical Considerations About Gait and Postural Dysfunctionsmentioning

confidence: 97%

Gait Analysis in Neurorehabilitation: From Research to Clinical Practice

Bonanno

Nunzio²,

Quartarone

et al. 2023

Bioengineering

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When brain damage occurs, gait and balance are often impaired. Evaluation of the gait cycle, therefore, has a pivotal role during the rehabilitation path of subjects who suffer from neurological disorders. Gait analysis can be performed through laboratory systems, non-wearable sensors (NWS), and/or wearable sensors (WS). Using these tools, physiotherapists and neurologists have more objective measures of motion function and can plan tailored and specific gait and balance training early to achieve better outcomes and improve patients’ quality of life. However, most of these innovative tools are used for research purposes (especially the laboratory systems and NWS), although they deserve more attention in the rehabilitation field, considering their potential in improving clinical practice. In this narrative review, we aimed to summarize the most used gait analysis systems in neurological patients, shedding some light on their clinical value and implications for neurorehabilitation practice.

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Increased temporal stride variability contributes to impaired gait coordination after stroke

Cited by 18 publications

References 51 publications

Increased Spatiotemporal Variability after Stroke is not Just the Outcome of Walking Velocity

Increased Spatiotemporal Variability after Stroke is not Just the Outcome of Walking Velocity

Postural control exercise without using the upper limbs improves activities of daily living in patients with stroke

Gait Analysis in Neurorehabilitation: From Research to Clinical Practice

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