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Effect of stroke on step characteristics of obstacle crossing
C M Said1, P A Goldie, A E Patla
1Physiotherapy Department, Austin and Repatriation Medical Centre, West Heidelberg, Victoria, Australia. C.Said@latrobe.edu.au
Objective:
To compare spatial and temporal measures during lead limb obstacle crossing between subjects with stroke and healthy subjects.
Design:
Experimental, observational, with matched controls.
Setting:
Geriatric rehabilitation unit in a tertiary referral hospital.
Participants:
Distance data were available for 19 subjects with stroke and 19 able-bodied subjects. Temporal data were available for 16 subjects with stroke and 16 able-bodied subjects. Subjects with stroke were inpatients and had to be able to walk 10 meters without assistance or gait aid.
Intervention:
Subjects were required to step over high and wide obstacles, ranging from 1 to 8cm, and trials were videotaped.
Main Outcome Measures:
Toe clearance, preobstacle distance, postobstacle distance, step length, proportion of step length preobstacle, step time, preobstacle step time, postobstacle step time, and proportion of step time preobstacle were measured.
Results:
Mann-Whitney U tests were performed to determine differences between the 2 groups. Subjects with stroke had significantly higher toe clearance, smaller postobstacle distances, and greater step times than healthy subjects. Subjects with stroke did not demonstrate a significant reduction in preobstacle distance.
Conclusion:
By modifying their lead limb trajectory during obstacle crossing, persons with stroke reduce the risk of a trip due to toe contact, but the modification may expose them to other safety risks.