Gait assessment for neurologically impaired patients. Standards for outcome assessment

This study compared the temporal-distance (TD) gait values of two groups of neurologically impaired subjects with published TD gait values of healthy subjects and analyzed the influence of nine clinical characteristics on TD values in the neurologically impaired subjects. Velocity, cadence, step length, stride length, and ratio of stride length to lower extremity length were recorded for 37 subjects with hemiparesis and 24 subjects with multiple sclerosis. Temporal-distance values were well below normal values, even in functionally independent subjects. Overall, the subjects with hemiparesis had lower values than the subjects with multiple sclerosis. Of the nine characteristics examined, only diagnosis, etiologic factor (for hemiparesis), type of ambulation aid, and functional category were related significantly to TD values. Our findings suggest that TD gait performance goals for patients with neurological impairment should be based on values from impaired rather than healthy subjects and that these goals should be adjusted for the individual patient's diagnosis, etiologic factor, type of ambulation aid, and functional category.