Article

Curved walking requires complex adaptations, including shift of body
weight to counteract the ensuing centrifugal force, and the production of strides
of different length between legs. We hypothesized that gait capacities would be
more stressed in hemiparetic patients than in healthy subjects when walking along
curved, compared with straight, trajectories. METHODS: Twenty chronic, stabilized
stroke patients and 20 healthy subjects walked along straight or curved
trajectories. Mean cadence and gait velocity were off-line computed from video
recordings. An electronic walkway detected asymmetry of single support and degree
of foot yaw angle at mid-stance. Centre of pressure during standing was recorded
by posturography. RESULTS: Compared with linear walking, the velocity of curved
walking was not significantly smaller in patients, and was independent of
affected body side or direction of rotation. It was inversely correlated with
paretic limb weakness, asymmetry of single support, and shift of centre of
pressure toward the healthy side. External rotation of the paretic foot
relatively favoured curved walking toward the paretic side. CONCLUSION: Curved
locomotion is defective in stabilized stroke patients, but impairment is not
dependent on direction of rotation, indicating a shared task between legs or
occurrence of effective functional adaptation. These findings advocate
rehabilitation exercises targeting complex gait adaptations, including curved
walking.

Langue : ANGLAIS