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Updated: Jun 26, 2026
Asymmetric Walkway: A Novel Behavioral Assay for Studying Asymmetric Locomotion
Published on: January 15, 2016
Balance, Lateropulsion, and Gait Disorders in Subacute Stroke
Shenhao Dai1, Céline Piscicelli1, Emmanuelle Clarac1
1From the Neurorehabilitation Department (S.D., C.P., E.C., M.B., D.P.), Institute of Rehabilitation, Grenoble Alpes University Hospital, Echirolles; and Laboratoire de Psychologie et NeuroCognition, UMR CNRS 5105 (S.D., C.P., M.B., D.P.), and AGEIS EA 7407 (M.H.), University Grenoble Alpes, Grenoble, France.
Objective:
To test the hypothesis that impaired body orientation with respect to gravity (lateropulsion) would play a key role in poststroke balance and gait disorders.
Methods:
Cohort study of 220 individuals consecutively admitted to a neurorehabilitation ward after a first hemisphere stroke (DOBRAS cohort [Determinants of Balance Recovery After Stroke] 2012-2018, ClinicalTrials.gov: NCT03203109), with clinical data systematically collected at 1 month, then at discharge. Primary outcomes were balance and gait disorders, quantified by the Postural Assessment Scale for Stroke and the modified Fugl-Meyer Gait Assessment, to be explained by all deficits on day 30, including lateropulsion assessed with the Scale for Contraversive Pushing. Statistics comprised linear regression analysis, univariate and multivariate analyses, and receiver operating characteristic curves.
Results:
Lateropulsion was frequent, especially after right hemisphere stroke (RHS, D30, 48%; discharge 24%), almost always in right-handers. Among all deficits, impaired body orientation (lateropulsion) had the most detrimental effect on balance and gait. After RHS, balance disorders were proportional to lateropulsion severity, which alone explained almost all balance disorders at initial assessment (90%; 95% confidence interval [CI] [86-94], p < 0.001) and at discharge (92%; 95% CI 89-95, p < 0.001) and also the greatest part of gait disorders at initial assessment (66%; 95% CI 56-77, p < 0.001) and at discharge (68%; 95% CI 57-78, p < 0.001).
Conclusion:
Lateropulsion is the primary factor altering poststroke balance and gait at the subacute stage and therefore should be systematically assessed. Poststroke balance and gait rehabilitation should incorporate techniques devoted to misorientation with respect to gravity.
