Toe Clearance And Lower Limb Kinematics During Walking In Older Japanese Stroke Patients.

Abstract

The risk of falls is higher in stroke patients than in healthy older adults. Trips are a major cause of falls during walking and occur when the swing foot contacts the floor surface or an object. Toe clearance is one of the main indicators of risk for trips. Although the main reason for falls during walking is tripping, there are few reports concerning toe clearance during walking in stroke patients. PURPOSE: To examine toe clearance and lower limb kinematics during walking on a flat floor in older Japanese stroke patients. METHOD: Eleven stroke patients (age 68.1 ± 6.4 years) who lived at home and could walk independently and ten healthy older adults (age 66.4 ± 3.3 years) were recruited. The following kinematical parameters were measured while subjects walked on flat floor surfaces: (1) the vertical displacement of toe markers from the floor surface (toe clearance) and (2) the angular displacements and velocities of the hip, knee, and ankle. RESULTS: The group of stroke patients had significantly lower toe clearance in the paretic side than that in the group of healthy older adults during the first swing phase (about 0∼20% swing phase). During the first swing phase, the group of stroke patients also had significantly smaller knee flexion of the paretic side than the group of healthy older adults. CONCLUSION: Toe clearance and knee flexion during the first swing phase of walking appear to be lower in stroke patients than in healthy older adults. In order to reduce the incidence of falls resulting from trips, approaches to increase knee flexion in the paretic side of stroke patients should be developed. This research was supported in part by the 21st century COE (Center of Excellence) program.