Temporal, kinematic, and kinetic variables related to gait speed in subjects with hemiplegia: a regression approach

The gait speed that a patient selects is a well-known indicator of overall gait performance. The purpose of this study was to use multiple linear regression to assess the strength of association of temporal, kinematic, and kinetic gait variables with high walking speeds in patients with hemiplegia.

Thirty-two subjects (20 male, 12 female) with an average age of 61 years took part in a sagittal-plane gait study of both sides of the body.

Data from cinematographic film and a force plate obtained during multiple walking trials were used in a seven-segment link-segment kinetic model of the walking subject to yield temporal, kinematic, and kinetic variables.

Variables correlating significantly with self-selected speed included the maximum hip extension angle and the maximum hip flexion moment on the affected side, and the maximum ankle and hip powers on both sides. A stepwise regression identified variables most useful in predicting stride speed. For the affected side, these variables were the hip flexion moment, the ankle moment range, the knee moment range, and the proportion of double support. Together these variables explained 94% of the variation in gait speed. On the unaffected side, the variables were the percentage of stance phase, the maximum ankle power (push-off), and the maximum hip power (pull-off). They explained 92% of the variation in gait speed.

These results suggest that experimental studies are needed to assess the effects of treatment aimed at increasing ankle power and hip power and at decreasing the stance time on the affected side, and that these studies should be directed at obtaining a larger hip flexion moment and a larger ankle moment range on the unaffected side.