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.