Article

Little information exists about longitudinal changes in
spatiotemporal gait asymmetry during rehabilitation, despite it being a common
goal. Objectives. To describe longitudinal changes in spatiotemporal gait
asymmetry over rehabilitation and examine relationships with changes in other
poststroke impairments. METHODS: Retrospective chart reviews were conducted for
71 stroke rehabilitation inpatients. Admission and discharge measures of
spatiotemporal symmetry, velocity, motor impairment, mobility and balance were
extracted and change scores were calculated. Relationships between changes in
spatiotemporal symmetry and other change scores were investigated with Spearman
correlations. Individuals were divided into four groups (worse, no
change-symmetric, no change-asymmetric, improved) based on (1) symmetry/asymmetry
at admission and (2) symmetry change scores >minimal detectable change.
Differences in change scores between groups were investigated with analyses of
covariance using the admission value as a covariate. RESULTS: At admission, 59%
and 49% of individuals were asymmetric in swing time and step length,
respectively. Of these individuals, 21% and 14% improved swing symmetry or step
symmetry, respectively. In contrast, 30% improved gait velocity, 62% improved
functional balance and 73% improved functional mobility. Associations between
change in swing symmetry and change in paretic limb weight bearing in standing
and change in step symmetry and change in velocity were significant. There were
no significant differences in change scores between the symmetry groups.
CONCLUSIONS: The majority of asymmetric stroke patients did not improve
spatiotemporal asymmetry during rehabilitation despite the fact that velocity,
balance and functional mobility improved. Future work should investigate other
factors associated with improved spatiotemporal symmetry and interventions to
specifically improve it.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS