PTCohortAmerican journal of physical medicine & rehabilitation2024

The Association of Interlimb Coordination and Temporal Symmetry With Walking Function and Motor Impairment After Stroke.

Brice Thomas Cleland, Sangeetha Madhavan

PMID 38709654

WHAT IT FOUND

Worse interlimb coordination was associated with slower walking and greater motor impairment in people with chronic stroke.

These associations were stronger than those for temporal symmetry, suggesting coordination is a more relevant target for gait rehabilitation than symmetry.

Key findings

01Higher phase coordination index (worse interlimb coordination) was significantly associated with slower comfortable and maximal walking speeds and greater lower limb motor impairment.

02Temporal symmetry (stance time) was not associated with walking speed or endurance, but was associated with motor impairment, indicating it captures different aspects of gait than interlimb coordination.

03Interlimb coordination had stronger correlations with walking speed than temporal symmetry did, supporting the idea that coordination is a more functionally relevant construct.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study is cross-sectional and correlational, so it cannot prove that poor coordination causes slower walking or that improving coordination will improve speed. For 44% of the sample, coordination was measured from the short 10-meter walk test, which may not fully represent gait over longer distances, although a subset analysis showed high correlation between 10m and 6m measures. The associations found were moderate (R values around 0.36-0.45), meaning coordination explains only a portion of the variance in walking function. Participants were drawn from a clinical trial screening pool, which may introduce selection bias if they were more motivated or had specific characteristics typical of trial candidates.

Declared interests

The authors declared no conflicts of interest. The study used data from an ongoing clinical trial (NCT04477330), but the funding source for that trial is not specified in the provided text.

The easy way to misread this

Do not interpret the lack of association between interlimb coordination and walking endurance as evidence that coordination does not affect endurance. The study found a trend toward significance (p=0.09) but did not reach the threshold, and the sample size may have been insufficient to detect this specific relationship.

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