Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke

An-Lun Hsu, Pei-Fang Tang, Mei-Hwa Jan
Archives of Physical Medicine and Rehabilitation 2003, 84 (8): 1185-93

OBJECTIVE: To identify the most important impairments determining gait velocity and asymmetry in patients with mild to moderate stroke.

DESIGN: Descriptive analysis of convenience sample.

SETTING: Outpatient rehabilitation clinic of a hospital in Taiwan.

PARTICIPANTS: Twenty-six subjects with mild to moderate spastic hemiparesis after a single onset of stroke, all able to walk independently without any assistance or device.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Subjects' maximal muscle strength (isokinetic peak torque, total work), motor and sensation function, and ankle plantarflexor spasticity of the affected lower extremity were examined using the Cybex 6000 dynamometry, Fugl-Meyer Assessment, and Modified Ashworth Scale, respectively. Gait velocity, as well as temporal and spatial asymmetry, were evaluated when subjects walked at their comfortable and fast speeds by using the GaitMatII.

RESULTS: Regression analyses revealed that the total work isokinetic measures of the affected hip flexors and knee extensors were the most important independent determinants of the comfortable and fast gait velocities, respectively (R(2)=.57, R(2)=.72). Spasticity of the affected plantarflexors was the most important independent determinant of temporal and spatial gait asymmetry during comfortable-speed (R(2)=.76 for temporal asymmetry; R(2)=.46 for spatial asymmetry) and fast-speed (R(2)=.75 for temporal asymmetry; R(2)=.45 for spatial asymmetry) walking.

CONCLUSIONS: Gait velocity and asymmetry of patients with mild to moderate stroke were affected by different physical impairments. Whereas gait velocity was mainly affected by weakness of the affected hip flexors and knee extensors, gait asymmetry was influenced primarily by the degree of the spasticity of the affected ankle plantarflexors. Therapeutic interventions aiming to improve different aspects of gait performance of these patients may emphasize treatment of different impairments.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"