Related Experiment Video
Updated: Dec 18, 2025
Asymmetric Walkway: A Novel Behavioral Assay for Studying Asymmetric Locomotion
Published on: January 15, 2016
Lateral Perturbation-Induced and Voluntary Stepping in Fallers and Nonfallers After Stroke
Vicki L Gray1, Masahiro Fujimoto2, Mark W Rogers3
1Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, 100 Penn Street, Baltimore, MD 21201 (USA).
Objective:
A loss of balance poststroke from externally induced perturbations or during voluntary movements is often recovered by stepping. The purpose of this study was to characterize stepping behavior during lateral induced waist-pull perturbations and voluntary steps in community-dwelling fallers and nonfallers with chronic stroke.
Methods:
This study used a cohort design. Thirty participants >6 months poststroke were exposed to 24 externally triggered lateral waist-pull perturbations and 20 voluntary steps. Balance tolerance limit (BTL) (transition from single to multiple steps) and first step type were determined for the waist-pull perturbations. Step parameters of initiation time, velocity, first step length, and clearance were calculated at and above BTL and for the voluntary steps. Hip abductor/adductor torque, foot cutaneous sensation, and self-reported falls that occurred 6 months prior were evaluated.
Results:
Twelve participants were classified retrospectively as fallers and 18 as nonfallers. Fallers had a reduced BTL and took more medial first steps than nonfallers. Above BTL, no between-group differences were found in medial steps. At BTL, the nonparetic step clearance was reduced in fallers. Above BTL, fallers took longer to initiate a paretic and nonparetic step and had a reduced nonparetic step length and clearance compared with nonfallers. There was a between-group difference in step initiation time for voluntary stepping with the paretic leg (P < .05). Fallers had a reduced paretic abductor torque and impaired paretic foot cutaneous sensation.
Conclusion:
A high fall rate poststroke necessitates effective fall prevention strategies. Given that more differences were found during perturbation-induced stepping between fallers and nonfallers, further research assessing perturbation-induced training on reducing falls is needed.
Impact:
Falls assessments should include both externally induced perturbations along with voluntary movements in determining the fall risk.
More Related Videos
08:11Assessing Forelimb Function after Unilateral Cervical SCI using Novel Tasks: Limb Step-alternation, Postural Instability and Pasta Handling
Published on: September 16, 2013
07:28Author Spotlight: Using the MouseWalker to Quantify Locomotor Dysfunction in a Mouse Model of Spinal Cord Injury
Published on: March 24, 2023