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

Yasuhiro Inui1,2, Naomichi Mizuta3,4, Shintaro Fujii1,5

  • 1Department of Neurorehabilitaion, Kio University, Nara, Japan.

Topics in Stroke Rehabilitation
|April 21, 2025
PubMed
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This summary is machine-generated.

People with stroke (PwS) adapt differently to uneven surfaces based on their walking ability. Lower-functioning PwS prioritize stability by reducing speed, while higher-functioning PwS show more flexible, though less stable, adaptations.

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:

Keywords:
Strokeco-contractiongait speedgait stabilityuneven surfacewalking

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  • 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.