Effect of Walking Adaptability on an Uneven Surface by a Stepping Pattern on Walking Activity After Stroke

Real-world walking activity is important for poststroke patients because it leads to their participation in the community and physical activity. Walking activity may be related to adaptability to different surface conditions of the ground. The purpose of this study was to clarify whether walking ada...

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Main Authors: Yusuke Sekiguchi, Keita Honda, Shin-Ichi Izumi
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-01-01
Series:Frontiers in Human Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnhum.2021.762223/full
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author Yusuke Sekiguchi
Keita Honda
Shin-Ichi Izumi
Shin-Ichi Izumi
author_facet Yusuke Sekiguchi
Keita Honda
Shin-Ichi Izumi
Shin-Ichi Izumi
author_sort Yusuke Sekiguchi
collection DOAJ
description Real-world walking activity is important for poststroke patients because it leads to their participation in the community and physical activity. Walking activity may be related to adaptability to different surface conditions of the ground. The purpose of this study was to clarify whether walking adaptability on an uneven surface by step is related to daily walking activity in patients after stroke. We involved 14 patients who had hemiparesis after stroke (age: 59.4 ± 8.9 years; post-onset duration: 70.7 ± 53.5 months) and 12 healthy controls (age: 59.5 ± 14.2 years). The poststroke patients were categorized as least limited community ambulators or unlimited ambulators. For the uneven surface, the study used an artificial grass surface (7 m long, 2-cm leaf length). The subjects repeated even surface walking and the uneven surface walking trials at least two times at a comfortable speed. We collected spatiotemporal and kinematic gait parameters on both the even and uneven surfaces using a three-dimensional motion analysis system. After we measured gait, the subjects wore an accelerometer around the waist for at least 4 days. We measured the number of steps per day using the accelerometer to evaluate walking activity. Differences in gait parameters between the even and uneven surfaces were calculated to determine how the subjects adapted to an uneven surface while walking. We examined the association between the difference in parameter measurements between the two surface properties and walking activity (number of steps per day). Walking activity significantly and positively correlated with the difference in paretic step length under the conditions of different surface properties in the poststroke patients (r = 0.65, p = 0.012) and step width in the healthy controls (r = 0.68, p = 0.015). The strategy of increasing the paretic step length, but not step width, on an uneven surface may lead to a larger base of support, which maintains stability during gait on an uneven surface in poststroke patients, resulting in an increased walking activity. Therefore, in poststroke patients, an increase in paretic step length during gait on an uneven surface might be more essential for improving walking activity.
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spelling doaj.art-c8d812448f1d4b1ca766e309942b300e2022-12-21T19:24:15ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612022-01-011510.3389/fnhum.2021.762223762223Effect of Walking Adaptability on an Uneven Surface by a Stepping Pattern on Walking Activity After StrokeYusuke Sekiguchi0Keita Honda1Shin-Ichi Izumi2Shin-Ichi Izumi3Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, JapanDepartment of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, JapanDepartment of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, JapanDepartment of Physical Medicine and Rehabilitation, Graduate School of Biomedical Engineering, Tohoku University, Sendai, JapanReal-world walking activity is important for poststroke patients because it leads to their participation in the community and physical activity. Walking activity may be related to adaptability to different surface conditions of the ground. The purpose of this study was to clarify whether walking adaptability on an uneven surface by step is related to daily walking activity in patients after stroke. We involved 14 patients who had hemiparesis after stroke (age: 59.4 ± 8.9 years; post-onset duration: 70.7 ± 53.5 months) and 12 healthy controls (age: 59.5 ± 14.2 years). The poststroke patients were categorized as least limited community ambulators or unlimited ambulators. For the uneven surface, the study used an artificial grass surface (7 m long, 2-cm leaf length). The subjects repeated even surface walking and the uneven surface walking trials at least two times at a comfortable speed. We collected spatiotemporal and kinematic gait parameters on both the even and uneven surfaces using a three-dimensional motion analysis system. After we measured gait, the subjects wore an accelerometer around the waist for at least 4 days. We measured the number of steps per day using the accelerometer to evaluate walking activity. Differences in gait parameters between the even and uneven surfaces were calculated to determine how the subjects adapted to an uneven surface while walking. We examined the association between the difference in parameter measurements between the two surface properties and walking activity (number of steps per day). Walking activity significantly and positively correlated with the difference in paretic step length under the conditions of different surface properties in the poststroke patients (r = 0.65, p = 0.012) and step width in the healthy controls (r = 0.68, p = 0.015). The strategy of increasing the paretic step length, but not step width, on an uneven surface may lead to a larger base of support, which maintains stability during gait on an uneven surface in poststroke patients, resulting in an increased walking activity. Therefore, in poststroke patients, an increase in paretic step length during gait on an uneven surface might be more essential for improving walking activity.https://www.frontiersin.org/articles/10.3389/fnhum.2021.762223/fullwalking adaptabilitywalking activitycompensatory movementstrokeuneven surface
spellingShingle Yusuke Sekiguchi
Keita Honda
Shin-Ichi Izumi
Shin-Ichi Izumi
Effect of Walking Adaptability on an Uneven Surface by a Stepping Pattern on Walking Activity After Stroke
Frontiers in Human Neuroscience
walking adaptability
walking activity
compensatory movement
stroke
uneven surface
title Effect of Walking Adaptability on an Uneven Surface by a Stepping Pattern on Walking Activity After Stroke
title_full Effect of Walking Adaptability on an Uneven Surface by a Stepping Pattern on Walking Activity After Stroke
title_fullStr Effect of Walking Adaptability on an Uneven Surface by a Stepping Pattern on Walking Activity After Stroke
title_full_unstemmed Effect of Walking Adaptability on an Uneven Surface by a Stepping Pattern on Walking Activity After Stroke
title_short Effect of Walking Adaptability on an Uneven Surface by a Stepping Pattern on Walking Activity After Stroke
title_sort effect of walking adaptability on an uneven surface by a stepping pattern on walking activity after stroke
topic walking adaptability
walking activity
compensatory movement
stroke
uneven surface
url https://www.frontiersin.org/articles/10.3389/fnhum.2021.762223/full
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AT shinichiizumi effectofwalkingadaptabilityonanunevensurfacebyasteppingpatternonwalkingactivityafterstroke
AT shinichiizumi effectofwalkingadaptabilityonanunevensurfacebyasteppingpatternonwalkingactivityafterstroke