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Individuals Poststroke Do Not Perceive Their Spatiotemporal Gait Asymmetries as Abnormal
Clinton J Wutzke1, Richard A Faldowski2, Michael D Lewek3
1C.J. Wutzke, PhD, Interdisciplinary Program in Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and Veterans Affairs Medical Center, Washington, DC.
Physical Therapy
|April 4, 2015
Summary
People poststroke need greater gait asymmetry to consciously perceive it. Augmenting their usual asymmetry may help correct long-term gait problems.
Area of Science:
- Neuroscience
- Biomechanics
- Rehabilitation Science
Background:
- Spatiotemporal gait asymmetries persist poststroke, even with the capacity for symmetric walking.
- This persistence may stem from altered perception, where asymmetric gait is perceived as normal.
Purpose of the Study:
- To investigate how usual overground gait asymmetry affects conscious and unconscious perception of gait asymmetry in individuals poststroke.
Main Methods:
- An observational study involving 30 individuals poststroke.
- Participants walked on a split-belt treadmill, imposing varying step length and stance time asymmetries.
- Conscious awareness and subconscious detection thresholds for asymmetry were assessed and compared to overground gait.
Main Results:
- The magnitude of asymmetry required for conscious awareness was significantly higher than for subconscious detection or typical overground gait.
- Participants seemed to rely on their typical asymmetry type (step length or stance time) to perceive belt speed differences.
Conclusions:
- Asymmetry must exceed typical overground levels to be consciously perceived.
- Augmenting a patient's specific spatiotemporal asymmetry beyond their usual levels may be necessary to promote awareness and facilitate long-term correction of asymmetric gait patterns.
