Foot placement control impairments in persons with chronic stroke become more evident during optic-flow perturbations.
Joost Biere, Ramon J Boekesteijn, Tom J W Buurke and 3 others
PMID 41933350WHAT IT FOUND
When the virtual hallway swayed strongly side to side, people with chronic stroke placed their feet less accurately than controls.
The difference was not evident during steady walking. Controlled visual perturbations may reveal balance control problems.
Key findings
01The primary foot placement deviation outcome showed a significant leg-by-condition interaction only at strong optic-flow perturbation intensity, not at moderate intensity.
02Foot placement deviation was higher in both stroke legs than controls during perturbed walking, but not during unperturbed walking.
03There were no significant differences between the paretic and non-paretic legs in any condition.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 17 people with chronic stroke were analysed, and 3 enrolled participants were excluded because they needed the handrail during perturbation trials. The analysed stroke group was relatively high functioning and able to walk independently without the handrail, so the results may not apply to more severely affected or more fearful patients. Controls were restricted to 50-75 years, while stroke participants were not age restricted. The study tested only one balance control mechanism and did not quantify other contributors such as ankle-based modulation during stance. Fixed perturbation intensities were too difficult for some participants, so adjustable intensity may be needed.
Declared interests
Funders: Interreg NWE-RE:HOME, ZonMw-TopZorg (TZO), and Interreg Deutschland-Nederland. No author conflict-of-interest declarations are reported.
The easy way to misread this
Do not conclude that optic-flow perturbation training improves balance or reduces falls. This was a laboratory group comparison of foot placement control, not a treatment trial. The primary interaction reached significance only at the strong perturbation intensity.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →