Curved walking in hemiparetic patients

Area of Science:

• Neuroscience
• Biomechanics
• Rehabilitation Medicine

Background:

• Curved walking necessitates complex motor adaptations, including weight shifting to counter centrifugal forces and differential stride lengths.
• Gait capacities in individuals with hemiparesis are hypothesized to be more challenged during curved compared to straight-line walking.

Purpose of the Study:

• To investigate the gait adaptations and challenges faced by hemiparetic patients during curved walking compared to healthy individuals.
• To determine if the direction of curvature or affected body side influences gait performance in stroke patients.

Main Methods:

• Twenty chronic stroke patients with hemiparesis and 20 healthy subjects walked along straight and curved paths.
• Gait parameters (cadence, velocity) were analyzed from video recordings.
• An electronic walkway measured single support asymmetry and foot yaw angle, while posturography assessed center of pressure during standing.

Main Results:

• Curved walking velocity in patients was not significantly reduced compared to linear walking and was independent of the affected side or rotation direction.
• Velocity was inversely correlated with paretic limb weakness, single support asymmetry, and center of pressure shift towards the healthy side.
• External rotation of the paretic foot facilitated curved walking towards the paretic side.

Conclusions:

• Stabilized stroke patients exhibit defective curved locomotion, though impairment is not influenced by rotation direction, suggesting compensatory mechanisms or shared leg involvement.
• These findings support the integration of curved walking and other complex gait adaptations into rehabilitation programs for stroke survivors.