Relationship between gait variability and walking-related outcomes after stroke: a scoping review

Gait variability in patients with stroke is often related to gait stability. Although it is reasonable to expect that gait variability is associated with walking-related outcomes, this relationship is unclear. This scoping review aimed to summarize existing evidence on the relationship between gait variability and walking-related outcomes after stroke and to identify knowledge gaps to guide future research. The literature was searched in PubMed, WoS, CINAHL, MEDLINE, Scopus, PEDro, and Igaku Chuo Zasshi databases. Included studies investigated the relationship between gait variability and walking speed, balance, self-efficacy, independent walking, and falls in patients with stroke. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Twenty-two observational studies were included, of which six examined walking speed, three balance, three self-efficacy, three walking independence, and eight falls. Measurement devices included pressure-sensitive mats, accelerometers, inertial measurement units, and three-dimensional motion analysis systems. Gait variability was quantified using spatiotemporal, kinematic, and center-of-pressure parameters. Most studies demonstrated a low risk of bias. Gait variability showed associations or correlations with the following outcomes: walking speed ( r  = -0.586 to 0.61), the Berg Balance Scale ( r  = -0.567 to -0.744), the Activities-specific Balance Confidence Scale (partial R2  = 0.11-0.24), the Functional Ambulation Category ( r  = -0.586), and the fall risk (odds ratio: 0.717-5.98). Given heterogeneity in gait variability parameters and outcomes, future research should prioritize more clinically meaningful outcomes and robust study designs with larger samples to clarify how gait variability may be related to and potentially impact walking-related outcomes after stroke.