Obstacle crossing in subjects with stroke

Abstract

Objective: To study the ability of subjects with stroke to successfully step over an obstacle during ambulation.

Setting: A geriatric rehabilitation unit in a tertiary referral hospital.

Subjects: Twenty-four inpatients with stroke (median time poststroke 27 days, interquartile range 21 to 44.5 days) able to walk 10 m unassisted without walking aids; also, 22 healthy subjects.

Method: Subjects were required to step over obstacles of various heights and widths, ranging from 1cm to 8cm. A fail was scored if the obstacle was contacted by either lower limb or if assistance or upper limb support was required. The choice of leading limb and the presence of visual deficits and neglect were also recorded in the stroke subjects. Subjects were tested on two occasions.

Results: Significantly more fails were recorded for stroke subjects, with 13 subjects failing at least once. No preference was shown for leading either with the affected or with the unaffected leg. Stroke subjects showed inconsistent performance over the two testing sessions.

Conclusion: The ability to negotiate obstacles was compromised and inconsistent in stroke subjects undergoing inpatient rehabilitation. This suggests that gait safety in this population remains threatened.