Differences in uneven-surface walking characteristics: high-functioning vs low-functioning people with stroke

Area of Science:

• Neurorehabilitation
• Biomechanics
• Gait Analysis

Background:

• Gait parameter adjustments on uneven surfaces in people with stroke (PwS) vary with functional ability.
• Understanding these differences is crucial for targeted rehabilitation strategies.

Purpose of the Study:

• To investigate differences in gait adjustments on uneven surfaces between PwS with high and low functional abilities.
• To compare gait parameters based on even-surface walking speed (≥0.8 m/s vs. <0.8 m/s).

Main Methods:

• Assessed trunk acceleration (RMS), maximum joint angles, and lower limb co-contraction indexes during even and uneven walking.
• Compared a high-functioning group (HG, n=38, ≥0.8 m/s) with a low-functioning group (LG, n=24, <0.8 m/s).

Main Results:

• LG reduced gait speed more than HG on uneven surfaces.
• HG showed increased trunk acceleration variability, while LG did not, on uneven surfaces.
• LG had smaller increases in knee flexion during swing and no change in thigh co-contraction during stance compared to HG on uneven surfaces.

Conclusions:

• LG adopted a conservative strategy (reduced speed) for stability, indicating potential motor control impairments.
• HG displayed more flexible but less stable adaptations, with reduced thigh co-contraction suggesting an adaptive response.
• Gait adaptation to uneven terrain is significantly influenced by baseline walking function in people with stroke.