Effect of stroke on step characteristics of obstacle crossing

Abstract

Objective: To compare spatial and temporal measures during lead limb obstacle crossing between subjects with stroke and healthy subjects.

Design: Experimental, observational, with matched controls.

Setting: Geriatric rehabilitation unit in a tertiary referral hospital.

Participants: Distance data were available for 19 subjects with stroke and 19 able-bodied subjects. Temporal data were available for 16 subjects with stroke and 16 able-bodied subjects. Subjects with stroke were inpatients and had to be able to walk 10 meters without assistance or gait aid.

Intervention: Subjects were required to step over high and wide obstacles, ranging from 1 to 8cm, and trials were videotaped.

Main outcome measures: Toe clearance, preobstacle distance, postobstacle distance, step length, proportion of step length preobstacle, step time, preobstacle step time, postobstacle step time, and proportion of step time preobstacle were measured.

Results: Mann-Whitney U tests were performed to determine differences between the 2 groups. Subjects with stroke had significantly higher toe clearance, smaller postobstacle distances, and greater step times than healthy subjects. Subjects with stroke did not demonstrate a significant reduction in preobstacle distance.

Conclusion: By modifying their lead limb trajectory during obstacle crossing, persons with stroke reduce the risk of a trip due to toe contact, but the modification may expose them to other safety risks.