Article

Obstacle crossing is impaired in people following stroke. It is not
known whether people with stroke who fail an obstacle crossing task have more
falls or whether the gait adjustments used to cross an obstacle differ from those
used by people who pass the task. The purposes of this study were (1)
to identify whether a group of people with stroke who failed an obstacle crossing
task had a greater incidence of falling and (2) to determine whether people who
fail an obstacle crossing task utilize different gait adjustments. DESIGN: This
was a prospective, observational study. METHODS: Thirty-two participants with a
recent stroke were recruited. Participants walked at self-selected speed and
stepped over a 4-cm-high obstacle. Performance was rated as pass or fail, and
spatiotemporal, center of mass (COM), and center of pressure (COP) data were
collected. Prospective falls data were recorded for 20 participants over a
6-month period. RESULTS: The incidence of fallers was significantly higher
(incidence rate=0.833) in the group that failed the obstacle crossing task than
in the group that passed the task (incidence rate=0.143). The group that failed
the task had a slower walking speed and greater normalized separation between the
trail heel (unaffected support limb) and COM as the affected lead toe cleared the
obstacle. This group exhibited greater normalized times from affected lead toe
clearance to landing, unaffected trail toe clearance to landing, and affected
trail toe-off to toe clearance. LIMITATIONS: The sample size was small, and falls
data were available for only 20 participants. CONCLUSIONS: Obstacle crossing is
an important task to consider in people following stroke and may be useful in
identifying those at risk of falls.

Langue : ANGLAIS