Improving Spatiotemporal Gait Asymmetry Has Limited Functional Benefit for Individuals Poststroke. Issue 3 (July 2020)

• Record Type: Journal Article
• Authors: Ryan, Hannah P.; Husted, Carty; Lewek, Michael D.
• Is Part Of: Journal of neurologic physical therapy. Volume 44:Issue 3(2020:Jul.)
• Publication Date: 2020-07
• Subjects: community mobility -- human movement system -- physical activity -- stance time -- step length; Nervous system -- Diseases -- Physical therapy -- Periodicals; Nervous system -- Diseases -- Treatment -- Periodicals; 616.80462
• DOI: 10.1097/NPT.0000000000000321
• Languages: English
• ISSNs: 1557-0576

Abstract

Abstract : Background and Purpose: Prior literature suggests a relationship between spatiotemporal gait asymmetry and metabolic cost of walking, balance, endurance, quality of life, and physical activity in people with chronic stroke. Our purpose was to determine whether targeting spatiotemporal gait symmetry would concomitantly improve these measures. Methods: This study represents secondary outcome measures from a trial in which 48 participants with chronic stroke were randomized to groups that all targeted spatiotemporal gait asymmetry. Measures of balance, daily step count, endurance (6-minute walk test [6MWT), metabolic cost of walking, quality of life (Stroke Impact Scale [SIS]), and overground spatiotemporal asymmetries were collected 1 week prior to and following training. Separate analyses were performed for those who trained for spatial versus temporal asymmetry. The effect of time (pre/post) was examined for all measures and correlational analyses evaluated the potential relationships between changes in spatiotemporal asymmetry and all other measures. Results: Individuals who trained to target step length asymmetry improved balance, 6MWT distance, metabolic cost of walking, and SIS-Mobility. Individuals who trained to target stance time asymmetry improved balance, 6MWT distance, SIS-Mobility, and SIS-Global recovery scores. However, step length asymmetry improvements were only related to improved 6MWT distance ( P = 0.025; r = −0.49). Stance time asymmetry improvements were only related to improved metabolic cost of walking ( P = 0.031; r = 0.558). Discussion and Conclusions: Despite a targeted training approach and noted improvements in most measures, these changes did not appear to arise from improved spatiotemporal gait asymmetry. Furthermore, improvements in gait function observed in the laboratory setting did not appear to translate to increased community mobility. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A316 ). Abstract : Supplemental Digital Content is Available in the Text.