Does the ankle affect knee hyperextension during gait in hemiparetic stroke? A pilot study.

This was a pilot study of 12 participants, and the authors state the results should be considered with caution and not generalised to the whole stroke population. The sample may not have had enough statistical power to detect real associations, and only three participants presented with knee hyperextension during stance. The study was designed to test feasibility of methods for a larger study, not to establish whether ankle function causes knee hyperextension. Participants had to walk independently for at least 10 m and had no lower limb joint pathology, so the results do not apply to non-ambulatory or more complex patients. All outcome measures were undertaken by the first author. Recruitment occurred during the COVID-19 pandemic and only two facilities granted permission, which reduced the study pool. The paper noted that passive ankle range may not reflect active range during walking. The paper recommends that a larger study measure balance, mobility and functional level with appropriate outcome measures.

Do not conclude that ankle function causes knee hyperextension or that treating tibialis anterior tone will change gait. This was a 12-participant feasibility pilot, only three participants had knee hyperextension during stance, and the authors did not recommend the findings for clinical practice.