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Updated: Jul 9, 2026
Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults
Published on: November 7, 2014
Effects of spatial and temporal pre-verbal prioritized instructions on spatiotemporal gait parameters in stroke
1Department of Physical therapy, the Graduate School, Yonsei University, Seoul, Republic of Korea.
Background:
Gait asymmetry is common after stroke. However, the differential effects of spatial versus temporal verbal instructions on spatiotemporal gait parameters remain poorly understood. Verbal instructions may also be understood as a modulation of attentional focus that engages distinct neural control strategies.
Objective:
To investigate the effects of spatial and temporal pre-verbal prioritized instructions on spatiotemporal gait parameters compared with a no-prioritization condition in stroke patients.
Methods:
Twenty-seven stroke patients walked under three randomized conditions: no prioritization, spatial prioritization (matching step length equally), and temporal prioritization (rhythmic counting aloud to match step timing equally). Spatiotemporal gait parameters were measured using the GAITRite® system. Repeated-measures ANOVA was used for primary analysis, with velocity-adjusted ANCOVA used to examine whether symmetry changes were independent of gait velocity.
Results:
Significant main effects were found for velocity (F(2,52) = 13.917, p < .001), step time difference (F(2,52) = 5.463, p = .007), step time of less affected side (F(2,52) = 9.108, p < .001), step length of affected side (F(2,52) = 14.531, p < .001), and step length of less affected side (F(2,52) = 9.892, p < .001). Temporal prioritization produced significantly greater reduction in step time difference compared with both spatial prioritization and no prioritization, while producing less velocity reduction than spatial prioritization. Velocity-adjusted ANCOVA indicated that the step time difference effect remained significant after controlling for gait velocity (F(1,51) = 5.785, p = .020).
Conclusions:
Temporal prioritization instruction acutely produced greater temporal gait symmetry improvement with less velocity reduction compared with spatial prioritization. Clinicians may consider temporal verbal cues as a potential strategy to address temporal gait asymmetry, though longitudinal studies are needed to determine retention and motor learning effects.
