Abnormal Gait Movements Prior to a Near Fall in Individuals After Stroke

Abstract

ObjectiveTo investigate the abnormal kinematic and kinetic movements in the last gait cycle before a near fall in individuals poststroke, where a near fall is defined as a physical therapist feeling the need to stabilize a patient. DesignRetrospective study. SettingA rehabilitation center. ParticipantsTwenty-five adults (22 men, 3 women; N=25) with an average age of 66.3 years and mean duration from stroke of 4 months who required manual assistance for a sudden imbalance during routine 3-dimensional motion analysis. InterventionsNot applicable. Main Outcome MeasuresWe compared the averaged usual gait cycle and the last cycle before the near-falling gait cycle (pre–near-falling gait cycle). We obtained the following spatiotemporal parameters: gait velocity, gait cycle duration, mediolateral center of mass displacement, step length, step width, joint moments, and angular displacement of the trunk in a cycle. Peak values of joint moments and trunk angle displacement were calculated. ResultsEtiology for near falls included toe trip, mediolateral perturbation, and knee collapse. We found the following significant differences in the pre–near-falling gait cycle compared with the usual gait cycle: decreased gait velocity, prolonged total cycle time, and excessive mediolateral center of mass displacement. ConclusionsDecreased gait velocity, prolonged cycle time, and excessive mediolateral center of mass displacement may be a sign of an impending fall in people with impaired gait after stroke.