Effects of increasing non-paretic step length on paretic leg movement during hemiparetic gait: a pilot study.
Yuichi Tsushima, Kazuki Fujita, Hiroichi Miaki and 1 others
PMID 35937629WHAT IT FOUND
Telling stroke patients to take longer steps with their strong leg increased walking speed and hip extension.
It did not reduce knee flexion during the swing phase, suggesting this cue can be used to improve propulsion without compromising leg clearance.
Key findings
01Increasing non-paretic step length significantly improved gait speed, stride length, and trailing limb angle.
02The intervention did not limit peak knee flexion angle during the swing phase, contrary to the hypothesis that it would increase fall risk.
03Rectus femoris and soleus muscle activity increased during the pre-swing phase, while hip extension angle and velocity also increased.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a pilot study with only 15 participants, all of whom were male, limiting generalizability. There was no healthy control group, so it is unclear if the observed kinematic changes are specific to the stroke population. The study did not account for the influence of assistive devices, as 8 participants used a cane and 4 used an ankle-foot orthosis. The intervention was a single-session instruction, so long-term effects on gait retraining or functional outcomes were not assessed.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume this instruction is safe for all patients. The participants had sufficient knee range of motion and could walk unaided or with a cane; those with severe spasticity or poor balance were excluded.