Gait Asymmetry in Community-Ambulating Stroke Survivors

OBJECTIVES: To determine the prevalence and severity of asymmetry among independently ambulating stroke survivors and to establish the association between velocity and asymmetry. DESIGN: Descriptive analysis. SETTING: Research gait laboratory in a Canadian hospital. PARTICIPANTS: Community-dwelling, independently ambulating participants (N=54) with chronic stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Overground gait velocity, symmetry ratios for temporal and spatial step parameters, and motor impairment of the foot and leg. Spatiotemporal parameters were collected with a pressure-sensitive mat. Motor impairment was measured clinically with the Chedoke-McMaster Stroke Assessment. RESULTS: Thirty (55.5%) participants showed statistically significant temporal asymmetry and 18 (33.3%) exhibited statistically significant spatial asymmetry. Preferred velocity was negatively associated with temporal asymmetry (r=-.583, df=52, P<.001) but not spatial asymmetry (r=-.146, df=52, P=.29). Temporal asymmetry was also associated with motor recovery of the leg (r=-.644, df=35, P<.001) and foot (r=-.628, df=35, P<.001). CONCLUSIONS: The results of the current study illustrate that temporal asymmetry can be found in many independently ambulating stroke patients. The work highlights the need for a standard assessment of poststroke gait symmetry in light of the complex relationship with motor impairment and velocity.