Targeted verbal cues can immediately alter gait following stroke

Physical therapists use verbal cueing extensively during gait rehabilitation. Nevertheless, little is known about the ability of individuals post-stroke to make immediate changes to targeted spatiotemporal gait parameters from verbal commands. Additionally, adequate muscle strength may be necessary to promote positive alterations in gait.

To determine the influence of targeted verbal cues on spatiotemporal gait parameters for individuals with chronic stroke. Further, we assessed the potential of a relationship between cue-induced gait modifications and paretic lower limb strength.

Using a within-subjects design, twenty-seven adults with chronic stroke walked over a pressure mat with verbal cues to walk at (1) comfortable and (2) fast speeds, with increased (3) arm swing, (4) foot height, (5) step length, (6) push off, and (7) cadence. We also assessed lower extremity strength using a hand-held dynamometer. We measured gait speed, step length, stance time, and cadence for comparisons between conditions and performed correlational analyses to assess the influence of strength on gait alterations.

Specific cues elicited increased walking speed, cadence, step lengths and paretic limb stance time. Only greater paretic hip and knee flexion strength was related to the ability to increase cadence when cued to do so (r > 0.41).

With targeted verbal cueing, clinicians can improve step length, gait speed, stance time and cadence for individuals with chronic stroke. Lower extremity strength does not appear to be related to the ability to alter gait with verbal cueing in individuals with chronic stroke.