Over-ground walking on level and sloped surfaces in people with stroke compared to healthy matched adults

Abstract

Purpose: To investigate the basic spatio-temporal gait characteristics of people with stroke whilst walking on sloped and level terrain, and to compare this performance to healthy matched adults. Method: Fifteen community dwelling people with stroke who walked with a hemiplegic gait and a reference group of 15 adults without impairments matched for sex, age and height participated in this descriptive, observational study. Basic gait spatio-temporal measures were recorded at self-selected speed across a GAITRite mat placed on level, uphill and downhill (ramp gradient 1:14 or 4.1°) surfaces. Measures recorded were gait speed, cadence, step length, support base, single and double limb support duration and step length symmetry. Group and walking condition effects were assessed by two separate 2-way (group × slope) repeated measures multivariate analysis of variance. Results: The stroke group walked slower (p < 0.001) than the reference group for all conditions. Within-group analyses found the stroke group decreased their speed and step length when walking downhill compared to level and uphill walking (p < 0.001). In contrast, the reference group maintained speed across all walking conditions. Conclusions: The findings suggest that walking on slopes affects gait speed in people with stroke and this may have implications when walking in the community.Implications for RehabilitationAlthough a high percentage of people achieve walking independence following a stroke, few achieve independent community mobility.Walking on slopes is an important aspect of community mobility.When walking down a standard gradient ramp, people with stroke reduced their speed and step length, relative to level over-ground and uphill walking.It is recommended that attention be directed to assessment and treatment of walking on slopes as part of stroke rehabilitation, as this may have implications when walking in the community.