PTOTOtherJournal of neuroengineering and rehabilitation2023

Speed-dependent biomechanical changes vary across individual gait metrics post-stroke relative to neurotypical adults.

Sarah A Kettlety, James M Finley, Darcy S Reisman and 2 others

PMID 36703214

WHAT IT FOUND

Walking faster improves some stroke gait mechanics but worsens others relative to neurotypical adults.

For many patients, fast walking alone does not make their overall gait pattern look like a typical walker's, suggesting speed training needs to be paired with other techniques to fix specific movement faults.

Key findings

01Fast walking reduced the difference in step length asymmetry between people post-stroke and neurotypical adults, but increased the difference in double-limb support time asymmetry.

02When all gait metrics were analyzed together, the overall walking patterns of people post-stroke and neurotypical adults became more distinct at faster speeds, not more similar.

03People post-stroke who walked with a gait pattern similar to neurotypical adults had significantly lower leg motor impairment scores, regardless of their walking speed.

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

Data came from three different studies with different protocols and motion capture setups, which introduces variability. The study did not include force plate data (ground reaction forces) or muscle activity data (EMG), so the underlying causes of the movement changes (like muscle weakness or spasticity) could not be directly measured. Kinematic data for the non-paretic (unaffected) leg was missing for many participants, so the analysis only looked at the affected side. This was a cross-sectional analysis of existing data, not a randomized trial of an intervention, so it describes associations rather than proving that fast walking causes these specific changes over time.

Declared interests

The authors declared no competing interests. The work was supported by various NIH institutes and the American Heart Association.

The easy way to misread this

Do not interpret 'improved step length symmetry' as evidence that fast walking normalizes overall gait. The study found that when all metrics are considered together, the overall walking pattern of people post-stroke actually becomes more distinct from neurotypical adults at faster speeds, not less.

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