Gait initiation is dependent on the function of the paretic trailing limb in individuals with stroke

The purposes of this study were to compare the gait initiation task between individuals with chronic stroke and age-matched healthy controls, to determine whether the observed differences between groups could be attributed to the presence of a stroke or to differences in gait initiation speed, and to establish the gait initiation variables that relate with a faster gait initiation speed. All subjects initiated gait at their preferred speed, while control subjects were also asked to initiate gait at a speed that was comparable to the stroke group. It was found that while many temporal and kinetic differences were observed between the two groups, most were simply due to differences in gait initiation speed. Two variables that remained different when speed was controlled were the magnitude of the antero-posterior impulse generated by the paretic limb when it was used as either the leading or trailing limb. Kinetic parameters of the trailing limb (i.e. peak antero-posterior force and impulse) were also found to correlate with the gait initiation speed for the non-paretic lead limb condition. The results suggest that the propulsive function of the paretic limb when used as the trailing limb is a key area to address in the rehabilitation of gait initiation for individuals with stroke.