Locomotor circumvention strategies are altered by stroke: I. Obstacle clearance.
Anuja Darekar, Anouk Lamontagne, Joyce Fung
PMID 28615042WHAT IT FOUND
People with chronic stroke and healthy people kept larger clearance from moving obstacles while walking or using a joystick, but some stroke walkers got closer at crossing and collided.
Those with poorer walking and balance confidence tended to veer toward the obstacle side.
Key findings
01Both groups kept larger clearance from moving obstacles than from stationary obstacles in walking and joystick tasks.
02In walking, stroke participants had a smaller closest distance while crossing moving obstacles than stationary obstacles, and some collided.
03Stroke walkers who veered toward the same side as the approaching obstacle had slower gait, lower balance confidence, worse motor control, and larger clearance than those who veered away.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study had 12 stroke participants and 12 healthy control participants, and the authors state that the relatively smaller sample size limited evaluation of which factors affected circumvention. The stroke participants had to walk at least 30 m, with or without a walking aid, so results may not apply to people who cannot walk that far. People with visual field defects or neglect were excluded, so results may not apply to those common stroke problems. The obstacle speed was fixed at 0.75 m/s while participants walked at different speeds, which may have affected clearance and collisions. The joystick task was not directly comparable with walking because the protocols differed. The study did not evaluate the effect of walking speeds on circumvention strategies.
Declared interests
Canadian Institutes of Health Research funded the work. The supplied text does not report other conflicts of interest or whether the funder designed or wrote the study.
The easy way to misread this
Do not read larger clearance as proof of safer walking. In the walking task, stroke participants still had a smaller closest distance while crossing moving obstacles and some collided, and the paper did not test an intervention.