Gait after stroke: initial deficit and changes in temporal patterns for each gait phase

Abstract

Objective: To examine which phases of the gait cycle contributed to decreased gait velocity after stroke.

Design: Experimental.

Setting: Inpatient rehabilitation centers.

Participants: Forty-two patients with unilateral first stroke who were able to walk 10 meters; and 42 age- and gender-matched controls with no history of stroke.

Interventions: Not applicable.

Main outcome measures: Deficit and change expressed as duration (s) and proportion (%) for the 4 phases of the gait cycle at the time of admission to rehabilitation (test 1), a median of 31 days poststroke onset, and again 8 weeks later (test 2). Affected and unaffected single-limb support (SLS) and initial double-limb support (DLS) were compared.

Results: At tests 1 and 2, the durations of the 2 DLS and unaffected SLS phases were significantly (p <.001) longer in the stroke patients than in control subjects. No difference was found between the 2 groups for duration of affected SLS at either test time. Significant (p <.001) decreases occurred over the 8-week period in the 3 phases identified to be abnormally long at test 1.

Conclusion: If the goal of rehabilitation is to increase gait velocity and normalize the gait pattern, treatment should focus on decreasing the DLS and unaffected SLS phases of the gait cycle.