Walking Speed Adaptability and Speed-related Changes in Spatiotemporal Gait Parameters, Symmetry, and Variability of Hemiplegic Gait in Patients following Stroke

Purpose: Walking speed adaptability is essential in activities of daily living. We investigated walking speed adaptability and walking speed associated changes in spatiotemporal characteristics of gait parameters, symmetry, and stride-to-stride variability in hemiplegic gait of stroke patients. Methods: Nineteen patients following a single onset of stroke walked at their comfortable, fast, and slow speeds for six trials each without using any assistance or device Walking speed, spatiotemporal gait parameters, step length asymmetry index (a spatial asymmetry index), single support time asymmetry index (a temporal asymmetry index), and stride-to-stride variability of spatiotemporal gait parameters were investigated for each walking speed condition. Results: The fast, comfort, and slow walking speeds of the subjects were 1.01±0.30, 0.66±0.18, and 0.43±0.19 m/sec, respectively, and were significantly different from each other (p＜0.017). There were also significant differences in the majority of the investigated spatiotemporal gait parameters, except for stride width, across the three speed conditions (p＜0.017). The stride-to-stride variability of all investigated gait parameters, except for stride width, and the single support time asymmetry index were significantly greater in the slow-speed walking condition than in the other two speed conditions (p＜0.017). Conclusions: Walking speed adaptability is preserved, but limited, in hemiplegic patients following mild to moderate stroke. These patients are able to modulate spatiotemporal gait parameters of both unaffected and affected legs to achieve such adaptability. Patients presented the greatest temporal asymmetry and stride-to-stride variability in most of the spatiotemporal gait parameters while walking at slow speed, compared to walking at the other two speeds. We suggest that to enhance walking speed adapt-ability, symmetry, and stride-to-stride consistency, patients with stroke may practice walking at their comfortable and fast speeds, instead of at a slow speed cautiously.