Article

Multiple aspects of gait are typically impaired post-stroke.
Asymmetric gait is common as a consequence of unilateral brain lesions.
The relationship between the resulting asymmetric gait and impairments in the ability
to properly coordinate the reciprocal stepping activation of the legs is not
clear. The objective of this exploratory study is to quantify the effects of
hemiparesis on two putatively independent aspects of the bilateral coordination
of gait to gain insight into mechanisms and their relationship and to assess
their potential as clinical markers. METHODS: Twelve ambulatory stroke patients
and age-matched healthy adults wore a tri-axial piezo-resistive accelerometer and
walked back and forth along a straight path in a hall at a comfortable walking
speed during 2 minutes. Gait speed, gait asymmetry (GA), and aspects of the
bilateral coordination of gait (BCG) were determined. Bilateral coordination
measures included the left-right stepping phase for each stride phii, consistency
in the phase generation phi_CV, accuracy in the phase generation phi_ABS, and
Phase Coordination Index (PCI), a combination of accuracy and consistency of the
phase generation. RESULTS: Group differences (p < 0.001) were observed for gait
speed (1.1 +/- 0.1 versus 1.7 +/- 0.1 m/sec for patients and controls,
respectively), GA (26.3 +/- 5.6 versus 5.5 +/- 1.2, correspondingly) and PCI
(19.5 +/- 2.3 versus 6.2 +/- 1.0, correspondingly).
A significant correlation
between GA and PCI was seen in the stroke patients (r = 0.94; p < 0.001), but not
in the controls. CONCLUSIONS: In ambulatory post-stroke patients, two gait
coordination properties, GA and PCI, are markedly impaired. Although these
features are not related to each other in healthy controls, they are strongly
related in stroke patients, which is a novel finding. A measurement approach
based on body-fixed sensors apparently may provide sensitive markers that can be
used for clinical assessment and for enhancing rehabilitation targeting in post-stroke patients.

Langue : ANGLAIS