Post-stroke deficits in the step-by-step control of paretic step width.
Katy H Stimpson, Lauren N Heitkamp, Aaron E Embry and 1 others
PMID 30856525WHAT IT FOUND
In chronic stroke, paretic steps showed weaker step-by-step adjustment of step width to body motion than non-paretic steps.
The paretic foot landed farther from the pelvis and balance margin varied more, but no one fell.
Key findings
01The relationship between pelvis motion and step width was generally weaker for paretic steps than non-paretic steps.
02Walking speed did not affect the primary measures of step-width control.
03Paretic steps placed the foot farther laterally from the pelvis and were followed by a larger and more variable mediolateral margin of stability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 20 participants were studied. All participants could already walk independently on a treadmill for at least 3 minutes, so it says little about more impaired walkers. No participants fell, so the study did not show whether these patterns cause falls. The study did not measure muscle weakness, proprioception, range of motion, foot drop, or response to external perturbations. Only treadmill walking was tested. The analysis used gait kinematics only, so it cannot separate active muscle control from passive mechanical effects.
Declared interests
The authors declared no conflicts of interest. The publication types list NIH extramural and U.S. government non-PHS research support.
The easy way to misread this
Do not read the paretic-side deficit as proof that this causes falls or that training step width will prevent falls. No participants fell, and the study tested no intervention.