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Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients
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Relationships between gait variability and ambulatory activity post stroke.

Lisa A Zukowski1,2, Jody A Feld3, Carol A Giuliani1,3

  • 1a Division of Physical Therapy, Department of Allied Health Sciences , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.

Topics in Stroke Rehabilitation
|March 27, 2019
PubMed
Summary

Gait variability in distracting environments after stroke is linked to daily walking activity. This suggests real-world walking assessments could improve stroke rehabilitation.

Keywords:
Strokeambulatory activitycognitiondual-taskgaitvariability

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Area of Science:

  • Rehabilitation Science
  • Neuroscience
  • Biomechanics

Background:

  • Fall risk and balance confidence are known to be associated with gait variability and ambulatory activity post-stroke.
  • The relationship between gait variability and ambulatory activity post-stroke remains unclear, particularly under naturalistic conditions.

Purpose of the Study:

  • To investigate the relationship between spontaneous, daily ambulatory activity and gait variability in adults post-stroke.
  • To examine gait variability during single-task and dual-task walking in both low- and high-distraction environments.

Main Methods:

  • A cross-sectional study involving 16 community-dwelling adults post-stroke.
  • Spatiotemporal gait parameters were measured during single- and cognitive-motor dual-task walking in varied distraction settings.
  • Gait variability (coefficient of variation) and daily ambulatory activity (walking bout duration, steps per day) were analyzed.

Main Results:

  • Stride duration variability in high-distraction settings negatively correlated with all ambulatory activity measures.
  • Dual-task stride duration variability showed the strongest negative correlation with average walking duration.
  • In low-distraction settings, single-task stride duration variability was negatively related to maximum walking duration.

Conclusions:

  • Stride duration variability in distracting environments, with or without cognitive load, relates to ambulatory activity in stroke survivors.
  • Clinical assessments incorporating attentional demands of real-world walking may benefit stroke rehabilitation.