Characteristics of Ground Reaction Force Variability During Walking in Post-Stroke Patients

Gait impairment in post-stroke patients increases the risk of falls, but the role of ground reaction force variability (GRF variability) in controlling gait stability remains unclear. The objectives of this study were (1) to clarify the differences in GRF variability during walking between post-stroke patients and age-matched controls and (2) to identify the differences in GRF variability between post-stroke patient fallers and non-fallers. Sixteen post-stroke patients (age: 72.19 ± 8.54, six female, four fallers: age: 71.75 ± 11.32, twelve non-fallers: age: 72.33 ± 8.03) and nineteen age-matched controls (age: 68.63 ± 5.73, nine female) participated. GRF variability was measured using shoe sensors during walking. After adjusting for walking speed, the anterior-posterior (AP) GRF variability on the paretic side in the 91-100% stance phase was significantly lower in the post-stroke patients (F = 3.721, p = 0.038). This phase's AP GRF variability was not correlated with Berg Balance Scale scores. Furthermore, the faller group in stroke patients showed the AP GRF variability on the paretic side was lower in the 41-50% (W = 17, p = 0.045), 51-60% (W = 16, p = 0.045), 61-70% (W = 16, p = 0.045), and 91-100% (W = 23, p = 0.045) sub-stance phases. After adjusting for sex and orthosis, the sensitivity analysis showed no significant intergroup difference. This suggested an adaptive control mechanism for maintaining gait and avoiding falls in post-stroke patients.