Does the Hawthorne effect influence gait assessment in stroke patients?

Area of Science:

• Rehabilitation Medicine
• Movement Science
• Clinical Biomechanics

Background:

• Gait assessments are crucial for post-stroke rehabilitation, guiding treatment and quantifying impairments.
• The Hawthorne effect, where behavior changes due to observation, may influence these assessments.
• This phenomenon has not been adequately studied in individuals post-stroke.

Purpose of the Study:

• To investigate the Hawthorne effect on post-stroke gait assessment.
• To differentiate between simple observation and observation with awareness of measurement.
• To determine if the Hawthorne effect impacts clinical decision-making in stroke rehabilitation.

Main Methods:

• Twenty adults post-stroke participated in the study.
• Gait was assessed under three conditions: unobserved, observed, and observed with awareness of measurement.
• Spatiotemporal gait parameters, including gait speed, were measured using inertial measurement units.

Main Results:

• Gait speed, stride length, and stride time showed significant differences across conditions.
• Observation plus awareness of measurement led to increased gait speed and stride length, and decreased stride time compared to unobserved walking.
• Observed plus measured conditions showed higher gait speed and shorter stride time than observed conditions alone.

Conclusions:

• The Hawthorne effect, while influencing gait parameters post-stroke, resulted in small changes.
• These changes did not surpass minimal clinically important differences.
• The Hawthorne effect is unlikely to significantly affect clinical decision-making in post-stroke gait assessment.