Turning Capacity in Ambulatory Individuals Poststroke

Abstract

To compare turning capacity in ambulatory individuals poststroke with controls and to determine the relationship between turning capacity, functional ambulation, motor recovery, and gait asymmetry. This was a cross-sectional experimental study using community-dwelling, ambulatory chronic stroke survivors (n = 13) and age-matched able-bodied controls (n = 10). Neural impairment resulting from stroke was assessed by the Chedoke-McMaster Stroke Assessment for the leg and foot. Turning capacity was measured by the number of steps and time required to complete 45-, 90-, and 180-degree turns. Functional ambulation and balance were assessed by the 10-m walk test, Timed Up and Go test, Emory Functional Ambulation Profile, and the Berg Balance Scale. Gait asymmetry was measured by single-support gait asymmetry. Participants with stroke required a significantly greater number of steps and longer time to complete the 45-, 90-, and 180-degree turns compared with controls. The average number of steps or time required to turn 45, 90, or 180 degrees was not different whether the turns were made to the paretic side or to the nonparetic side in the participants with stroke or whether turns were made toward the dominant or nondominant side in the controls. In the participants with stroke, turning capacity for 180-degree turns to both the paretic and nonparetic side was significantly correlated to the 10-m walk test, Timed Up and Go test, Emory Functional Ambulation Profile, and Berg Balance Scale. Single-support gait asymmetry was also significantly correlated to 180-degree turning capacity. The results of this study demonstrate that turning capacity poststroke is compromised, as exemplified by the greater number of steps and time required to complete turns at each angle tested. Turning capacity was related to the degree of gait asymmetry and the level of functional ambulation. Further work is needed to elucidate the contribution of biomechanical and neurologic parameters of hemiplegic gait impairments to turning capacity.