OBJECTIVE: To explore the impact of a complex community environment on gait parameters (speed, step length and cadence) for community-dwelling participants with a previous stroke, and compare outcome measures commonly used in a clinical environment. DESIGN: Repeated measurement of participants in different environments. SETTING: One clinic and two community environments (suburban street and shopping mall). SUBJECTS: Thirty community-dwelling stroke participants with chronic stroke who were classified according to gait speed (20-50 m/min on 10-metre timed walk) as marginal community walkers. OUTCOME MEASURES: During a six-minute walk test (6MWT) a step activity monitor (SAM) and odometer were used to calculate gait speed, step length and cadence. The 10-metre timed walk (10MTW) was measured in a clinic environment. ANALYSIS: A mixed linear model examined differences in gait measurements in the different environments. Bland-Altman analysis illustrated agreement between gait speed measures (6MWT and 10MTW). RESULTS: A statistically significant, but not a clinically significant difference in gait speed between some environments was found. Gait speed was slowest in the mall and fastest in the street with a difference of only 2.1 m/min between these environments (95% confidence interval (CI) -3.8 to -0.5, P<0.01). Comparison of clinic 10MTW and street 6MWT showed wide limits of agreement (-18.5 to 16.9 m/min) which improved for clinic 6MWT and street 6MWT comparisons (-5.7 to 8.9 m/min). CONCLUSION: Despite residual gait deficit, the gait parameters of these chronic stroke survivors did not deteriorate markedly under challenging conditions. The 6MWT is recommended as a clinical measure for community ambulation.
OBJECTIVE: To explore the impact of a complex community environment on gait parameters (speed, step length and cadence) for community-dwelling participants with a previous stroke, and compare outcome measures commonly used in a clinical environment. DESIGN: Repeated measurement of participants in different environments. SETTING: One clinic and two community environments (suburban street and shopping mall). SUBJECTS: Thirty community-dwelling strokeparticipants with chronic stroke who were classified according to gait speed (20-50 m/min on 10-metre timed walk) as marginal community walkers. OUTCOME MEASURES: During a six-minute walk test (6MWT) a step activity monitor (SAM) and odometer were used to calculate gait speed, step length and cadence. The 10-metre timed walk (10MTW) was measured in a clinic environment. ANALYSIS: A mixed linear model examined differences in gait measurements in the different environments. Bland-Altman analysis illustrated agreement between gait speed measures (6MWT and 10MTW). RESULTS: A statistically significant, but not a clinically significant difference in gait speed between some environments was found. Gait speed was slowest in the mall and fastest in the street with a difference of only 2.1 m/min between these environments (95% confidence interval (CI) -3.8 to -0.5, P<0.01). Comparison of clinic 10MTW and street 6MWT showed wide limits of agreement (-18.5 to 16.9 m/min) which improved for clinic 6MWT and street 6MWT comparisons (-5.7 to 8.9 m/min). CONCLUSION: Despite residual gait deficit, the gait parameters of these chronic stroke survivors did not deteriorate markedly under challenging conditions. The 6MWT is recommended as a clinical measure for community ambulation.
Authors: Ava S T Storey; Ainslie M Myrah; Robyn A Bauck; Danielle M Brinkman; Shawn N Friess; Sandra C Webber Journal: Physiother Can Date: 2013 Impact factor: 1.037
Authors: Louis N Awad; Stuart A Binder-Macleod; Ryan T Pohlig; Darcy S Reisman Journal: Neurorehabil Neural Repair Date: 2014-11-10 Impact factor: 3.919
Authors: Louis N Awad; Darcy S Reisman; Tamara R Wright; Margaret A Roos; Stuart A Binder-Macleod Journal: Top Stroke Rehabil Date: 2014 Nov-Dec Impact factor: 2.119
Authors: D Meester; E Al-Yahya; A Dennis; J Collett; D T Wade; M Ovington; F Liu; A Meaney; J Cockburn; H Johansen-Berg; H Dawes Journal: Eur J Neurol Date: 2018-11-25 Impact factor: 6.089