Stroke-specific Movement Patterns During Passage Through a Narrow-Opening: A Cross-Sectional Study

PurposeIndividuals with stroke have difficulty rotating their trunk and adjusting their supporting foot when negotiating spatial constraints. This study aimed to classify movement patterns used when passing through narrow openings and to identify factors associated with stroke-specific patterns.MethodsTwenty-three individuals with stroke (age: 60.7 ± 10.1 years, time after stroke: 15.2 ± 21.1 months, subacute and chronic, independently ambulatory), 23 age-matched community-dwelling adults (61.0 ± 9.7 years), and 12 young adults (25.4 ± 2.5 years) were recruited. Participants walked through openings of various widths. Movement patterns were independently classified by three trained physical therapists, and inter-rater agreement was assessed. Generalized linear mixed models with participants as a random effect were used to examine associations between pattern selection and clinical/environmental factors.ResultsFive passing patterns were identified: (A) pivot, (B-1) early pivot, (B-2) early pivot with reverse trunk rotation, (C) multiple steps, and (D) no-rotation. Inter-rater agreement was substantial (Cohen's κ = .76). Stroke-specific patterns were patterns B-2 and C. The mixed-model analysis showed that B-2 and C were more likely with narrower openings (odds ratio [OR]: .52, 95% confidence interval [CI]: .39-.70; and OR: .18, 95% CI: .11-.32, respectively; both p < .001). TUG performance was not significantly associated with pattern C (OR: 1.22, 95% CI: .99-1.49, p = .056).ConclusionOpening width was associated with stroke-specific pattern selection. Multi-step strategies may reflect increased stability demands, whereas pivot-like strategies may be associated with better mobility. These findings may help clinicians assess movement behaviors in constrained environments.