Relationships between gait variability and ambulatory activity post stroke.
Lisa A Zukowski, Jody A Feld, Carol A Giuliani and 1 others
PMID 30909825WHAT IT FOUND
Stroke survivors who showed more variable step timing when walking in a busy lobby took fewer daily steps and had shorter walking bouts.
This link was absent when they walked in a quiet hallway, suggesting clinic tests may miss real-world activity predictors.
Key findings
01In a high-distraction environment, greater stride duration variability was significantly associated with fewer steps per day, shorter average walking bouts, and shorter maximum walking bouts.
02In a low-distraction environment, stride duration variability was only weakly related to maximum walking bout duration and not significantly related to other ambulatory activity measures.
03Stride length variability showed no significant correlations with any measure of ambulatory activity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was very small (n=16), which limits the generalizability of the findings and prevented regression analysis. The study excluded individuals with more than one fall in the previous year, so the results may not apply to those with higher fall risk. The cross-sectional design cannot determine causality; it is unclear if gait variability causes low activity or if low activity leads to deconditioning and variable gait. Gait variability measurements require specialized equipment (accelerometers) and are not currently easy to implement in standard clinical practice. The authors note that a larger sample size (45-50) would be needed to sufficiently power a regression analysis.
Declared interests
The authors report no conflicts of interest. The study was supported by the National Institutes of Health (N.I.H., Extramural).
The easy way to misread this
Do not assume that gait variability measured in a quiet clinic hallway predicts a patient's daily activity levels. The study found that this relationship only emerged when patients walked in a high-distraction environment, meaning standard clinic tests might miss patients who are at risk for low community ambulation.