Michiel Punt1, Sjoerd M Bruijn2, Sanne Roeles3, Ingrid G van de Port4, Harriet Wittink5, Jaap H van Dieën6. 1. Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands. Electronic address: Michiel.punt@hu.nl. 2. Move Research Institute Amsterdam, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Orthopedics, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China. 3. Department of Biomechanical Engineering, University of Strathclyde, Glasgow, United Kingdom; Department of Applied Research, Motekforce Link BV, Amsterdam, The Netherlands. 4. Revant Rehabilitation Center Breda, Breda, The Netherlands. 5. Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands. 6. Move Research Institute Amsterdam, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Steady-state gait characteristics appear promising as predictors of falls in stroke survivors. However, assessing how stroke survivors respond to actual gait perturbations may result in better fall predictions. We hypothesize that stroke survivors who fall have a diminished ability to adequately adjust gait characteristics after gait is perturbed. This study explored whether gait characteristics of perturbed gait differ between fallers and non fallers. METHOD: Chronic stroke survivors were recruited by clinical therapy practices. Prospective falls were monitored over a six months follow up period. We used the Gait Real-time Analysis Interactive Lab (GRAIL, Motekforce Link B.V., Amsterdam) to assess gait. First we assessed gait characteristics during steady-state gait and second we examined gait responses after six types of gait perturbations. We assessed base of support gait characteristics and margins of stability in the forward and medio-lateral direction. FINDINGS: Thirty eight stroke survivors complete our gait protocol. Fifteen stroke survivors experienced falls. All six gait perturbations resulted in a significant gait deviation. Forward stability was reduced in the fall group during the second step after a ipsilateral perturbation. INTERPRETATION: Although stability was different between groups during a ipsilateral perturbation, it was caused by a secondary strategy to keep up with the belt speed, therefore, contrary to our hypothesis fallers group of stroke survivors have a preserved ability to cope with external gait perturbations as compared to non fallers. Yet, our sample size was limited and thereby, perhaps minor group differences were not revealed in the present study.
BACKGROUND: Steady-state gait characteristics appear promising as predictors of falls in stroke survivors. However, assessing how stroke survivors respond to actual gait perturbations may result in better fall predictions. We hypothesize that stroke survivors who fall have a diminished ability to adequately adjust gait characteristics after gait is perturbed. This study explored whether gait characteristics of perturbed gait differ between fallers and non fallers. METHOD:Chronic stroke survivors were recruited by clinical therapy practices. Prospective falls were monitored over a six months follow up period. We used the Gait Real-time Analysis Interactive Lab (GRAIL, Motekforce Link B.V., Amsterdam) to assess gait. First we assessed gait characteristics during steady-state gait and second we examined gait responses after six types of gait perturbations. We assessed base of support gait characteristics and margins of stability in the forward and medio-lateral direction. FINDINGS: Thirty eight stroke survivors complete our gait protocol. Fifteen stroke survivors experienced falls. All six gait perturbations resulted in a significant gait deviation. Forward stability was reduced in the fall group during the second step after a ipsilateral perturbation. INTERPRETATION: Although stability was different between groups during a ipsilateral perturbation, it was caused by a secondary strategy to keep up with the belt speed, therefore, contrary to our hypothesis fallers group of stroke survivors have a preserved ability to cope with external gait perturbations as compared to non fallers. Yet, our sample size was limited and thereby, perhaps minor group differences were not revealed in the present study.
Authors: Nicholas K Reimold; Holly A Knapp; Alyssa N Chesnutt; Alexa Agne; Jesse C Dean Journal: IEEE Trans Neural Syst Rehabil Eng Date: 2021-02-26 Impact factor: 3.802