Abnormal Gait Movements Prior to a Near Fall in Individuals After Stroke.
Yuji Osada, Naoyuki Motojima, Yosuke Kobayashi and 1 others
PMID 34977538WHAT IT FOUND
In the single step before a near fall, stroke patients slowed down, took longer to complete the step, and shifted their body weight side-to-side more than usual.
Therapists should watch for these specific changes in gait to anticipate instability.
Key findings
01Gait velocity was significantly lower and total cycle time was significantly longer in the gait cycle immediately preceding a near fall compared to usual gait.
02Side-to-side movement of the center of mass was significantly larger in the pre-fall step, suggesting poor lateral control.
03Visual signs appearing one step before a near fall included slight toe trip, high steppage, and buckling knee.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study only analyzed near falls, not actual falls, so it is unknown if these signs predict real falls. Most participants were men (22 of 25), which introduces sex bias. The participants had low walking ability and often used assistive devices, so results may not apply to those who walk independently. Joint moments for the non-paretic limb could not be measured for the 14 participants using a cane on that side. The definition of a near fall relied partly on subjective therapist judgment captured on video.
The easy way to misread this
Do not assume these signs predict actual falls. The study analyzed near falls where patients were caught by therapists; no patients actually fell during the recorded trials, so the link to real-world injury risk is not established.