Article

There is little information about the quality of gait in the years
following stroke. Long-term changes in mobility, using global indices of
function, suggest a decline well after initial rehabilitation. However, global
indices of mobility do not reveal more specific changes in walking competency or
underlying gait-specific impairment. OBJECTIVES:
The authors used a
cross-sectional design with gait-specific measures (velocity and symmetry) to
investigate whether deterioration in gait occurs over the long term poststroke.
METHODS: Data were abstracted from a standardized database containing clinical
assessments and spatiotemporal gait analyses for 171 individuals with stroke.
Velocity and 3 expressions of symmetry ratios (swing time, stance time, and step
length) were calculated for each individual; they were then assigned to 1 of the
5 following groups: 0 to 3, 3 to 12, 12 to 24, 24 to 48, and >48 months
poststroke. RESULTS: Swing time, stance time, and step length symmetry
demonstrated a systematic linear trend toward greater asymmetry in groups in the
later stages poststroke, whereas velocity, neurological deficit, and
lower-extremity (LE) motor impairment did not. CONCLUSIONS: The quality of gait,
as measured by spatial and temporal symmetry, appears to worsen in later years.
These results suggest a dissociation between quantitative measures of gait, such
as velocity versus symmetry, and that these parameters may measure independent
features. A longitudinal study is needed to confirm the presence and to interpret
the clinical meaning of a long-term decline in specific parameters of poststroke
gait.

Langue : ANGLAIS