A novel biomechanical indicator for impaired ankle dorsiflexion function during walking in individuals with chronic stroke.
Shraddha Srivastava, John H Kindred, Bryant A Seamon and 4 others
PMID 37923642WHAT IT FOUND
In chronic stroke, paretic ankle movement speed and acceleration during swing tracked walking ability better than foot clearance or ankle angle.
They also stayed consistent across repeated testing.
Key findings
01Peak paretic ankle angular velocity and acceleration during swing were significantly related to dorsiflexion impairment, with Adj_R2 = 0.25 and Adj_R2 = 0.2.
02Peak paretic ankle angular velocity and acceleration had stronger correlations with most clinical walking ability measures than foot clearance or peak dorsiflexion angle.
03Test-retest reliability was excellent for peak paretic ankle angular velocity (ICC = 0.968) and peak paretic ankle angular acceleration (ICC = 0.947).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The analysis was retrospective and included only chronic stroke survivors with moderate to severe lower extremity paresis who could walk at least 10 ft and had self-selected treadmill speed of 1.0 m/s or less, so it may not apply to faster community ambulators or those who walk with an ankle-foot orthosis. There was no gold standard measure of dorsiflexion function during walking, so the validity of the new measures could not be fully tested. Correlations with clinical walking measures were mostly moderate, and the authors state that other post-stroke impairments also affect walking. Angular velocity and acceleration are speed dependent; the paper notes this, even though speed did not add variance in the stepwise model. Reliability was calculated only in 23 participants, and the measures were computed from laboratory motion capture rather than a clinical setup.
Declared interests
The article is tagged as supported by non-U.S. government, NIH extramural, and U.S. government non-PHS research funding. No explicit author conflict-of-interest statement is provided in the supplied text.
The easy way to misread this
Do not conclude that these measures are ready for routine clinic use or that changing them will improve walking. This study used motion capture in chronic stroke survivors and showed associations and test-retest reliability, not treatment effects.