A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors

Hollands, K; Pelton, TA; van der Veen, S; Alharbi, S; Hollands, MA

Abstract

Background: Although there is evidence that stroke survivors have reduced gait adaptability, the
underlying mechanisms and the relationship to functional recovery are largely unknown. We explored
the relationships between walking adaptability and clinical measures of balance, motor recovery and
functional ability in stroke survivors.
Methods: Stroke survivors (n = 42) stepped to targets, on a 6 m walkway, placed to elicit step
lengthening, shortening and narrowing on paretic and non-paretic sides. The number of targets missed
during six walks and target stepping speed was recorded. Fugl–Meyer (FM), Berg Balance Scale (BBS),
self-selected walking speed (SWWS) and single support (SS) and step length (SL) symmetry (using
GaitRite when not walking to targets) were also assessed. Stepwise multiple-linear regression was used
to model the relationships between: total targets missed, number missed with paretic and non-paretic
legs, target stepping speed, and each clinical measure.
Results: Regression revealed a significant model for each outcome variable that included only one
independent variable. Targets missed by the paretic limb, was a significant predictor of FM (F(1,40) = 6.54,
p = 0.014,). Speed of target stepping was a significant predictor of each of BBS (F(1,40) = 26.36, p < 0.0001),
SSWS (F(1,40) = 37.00, p < 0.0001). No variables were significant predictors of SL or SS asymmetry.
Discussion: Speed of target stepping was significantly predictive of BBS and SSWS and paretic targets
missed predicted FM, suggesting that fast target stepping requires good balance and accurate stepping
demands good paretic leg function. The relationships between these parameters indicate gait
adaptability is a clinically meaningful target for measurement and treatment of functionally adaptive
walking ability in stroke survivors.

Citation

Hollands, K., Pelton, T., van der Veen, S., Alharbi, S., & Hollands, M. (2016). A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors. Gait & Posture, 43, 170-175. https://doi.org/10.1016/j.gaitpost.2015.09.018

• Journal Article Type: Article
• Acceptance Date: Sep 17, 2015
• Online Publication Date: Sep 30, 2015
• Publication Date: Jan 1, 2016
• Deposit Date: Oct 19, 2015
• Journal: Gait & Posture
• Print ISSN: 0966-6362
• Electronic ISSN: 1879-2219
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 43
• Pages: 170-175
• DOI: https://doi.org/10.1016/j.gaitpost.2015.09.018
• Keywords: Gait, Adaptability, Stroke, Vision
• Publisher URL: http://dx.doi.org/10.1016/j.gaitpost.2015.09.018
• Related Public URLs: http://www.journals.elsevier.com/gait-and-posture/
• Additional Information: Projects : Visual Cue training to improve walking and turning after stroke: a pilot study