The Relationship Between Spatiotemporal Gait Asymmetry and Balance in Individuals With Chronic Stroke

in Journal of Applied Biomechanics

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Michael D. LewekUniversity of North Carolina at Chapel Hill

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Claire E. BradleyEmory University

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Clinton J. WutzkeUniversity of North Carolina at Chapel Hill

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Steven M. ZinderUniversity of South Florida

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Falls are common after stroke and often attributed to poor balance. Falls often occur during walking, suggesting that walking patterns may induce a loss of balance. Gait after stroke is frequently spatiotemporally asymmetric, which may decrease balance. The purpose of this study is to determine the relationship between spatiotemporal gait asymmetry and balance control. Thirty-nine individuals with chronic stroke walked at comfortable and fast speeds to calculate asymmetry ratios for step length, stance time, and swing time. Balance measures included the Berg Balance Scale, step width during gait, and the weight distribution between legs during standing. Correlational analyses determined the relationships between balance and gait asymmetry. At comfortable and fast gait speeds, step width was correlated with stance time and swing time asymmetries (r = 0.39−0.54). Berg scores were correlated with step length and swing time asymmetries (r = –0.36 to –0.63). During fast walking, the weight distribution between limbs was correlated with stance time asymmetry (r = –0.41). Spatiotemporal gait asymmetry was more closely related to balance measures involving dynamic tasks than static tasks, suggesting that gait asymmetry may be related to the high number of falls poststroke. Further study to determine if rehabilitation that improves gait asymmetry has a similar influence on balance is warranted.

Michael D. Lewek (Corresponding Author) is with the Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, and with the Interdisciplinary Program in Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, NC. Claire E. Bradley is with the Division of Physical Therapy, Emory University, Atlanta, GA. Clinton J. Wutzke is with the Interdisciplinary Program in Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, NC. Steven M. Zinder is with the Department of Orthopedics, University of South Florida, Tampa, FL.

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