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Published on: January 15, 2016
Abnormal Gait Movements Prior to a Near Fall in Individuals After Stroke
Yuji Osada1, Naoyuki Motojima2, Yosuke Kobayashi3
1Department of Health and Welfare, Tokushima Bunri University, Tokushima.
Objective:
To investigate the abnormal kinematic and kinetic movements in the last gait cycle before a near fall in individuals poststroke, where a near fall is defined as a physical therapist feeling the need to stabilize a patient.
Design:
Retrospective study.
Setting:
A rehabilitation center.
Participants:
Twenty-five adults (22 men, 3 women; N=25) with an average age of 66.3 years and mean duration from stroke of 4 months who required manual assistance for a sudden imbalance during routine 3-dimensional motion analysis.
Interventions:
Not applicable.
Main Outcome Measures:
We compared the averaged usual gait cycle and the last cycle before the near-falling gait cycle (pre-near-falling gait cycle). We obtained the following spatiotemporal parameters: gait velocity, gait cycle duration, mediolateral center of mass displacement, step length, step width, joint moments, and angular displacement of the trunk in a cycle. Peak values of joint moments and trunk angle displacement were calculated.
Results:
Etiology for near falls included toe trip, mediolateral perturbation, and knee collapse. We found the following significant differences in the pre-near-falling gait cycle compared with the usual gait cycle: decreased gait velocity, prolonged total cycle time, and excessive mediolateral center of mass displacement.
Conclusions:
Decreased gait velocity, prolonged cycle time, and excessive mediolateral center of mass displacement may be a sign of an impending fall in people with impaired gait after stroke.
