Gait after stroke: initial deficit and changes in temporal patterns for each gait phase.

OBJECTIVE

To examine which phases of the gait cycle contributed to decreased gait velocity after stroke.

DESIGN

Experimental.

SETTING

Inpatient rehabilitation centers.

PARTICIPANTS

Forty-two patients with unilateral first stroke who were able to walk 10 meters; and 42 age- and gender-matched controls with no history of stroke.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Deficit and change expressed as duration (s) and proportion (%) for the 4 phases of the gait cycle at the time of admission to rehabilitation (test 1), a median of 31 days poststroke onset, and again 8 weeks later (test 2). Affected and unaffected single-limb support (SLS) and initial double-limb support (DLS) were compared.

RESULTS

At tests 1 and 2, the durations of the 2 DLS and unaffected SLS phases were significantly (p <.001) longer in the stroke patients than in control subjects. No difference was found between the 2 groups for duration of affected SLS at either test time. Significant (p <.001) decreases occurred over the 8-week period in the 3 phases identified to be abnormally long at test 1.

CONCLUSION

If the goal of rehabilitation is to increase gait velocity and normalize the gait pattern, treatment should focus on decreasing the DLS and unaffected SLS phases of the gait cycle.