Biomechanical Correlates of Falls Risk in Gait Impaired Stroke Survivors
Increased falls risk is prevalent among stroke survivors with gait impairments. Tripping is the leading cause of falls and it is highly associated with mid-swing Minimum Foot Clearance (MFC), when the foot’s vertical margin from the walking surface is minimal. The current study investigated MFC char...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2022.833417/full |
| _version_ | 1818918627512942592 |
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| author | Hanatsu Nagano Catherine M. Said Catherine M. Said Catherine M. Said Catherine M. Said Lisa James William A. Sparrow Rezaul Begg |
| author_facet | Hanatsu Nagano Catherine M. Said Catherine M. Said Catherine M. Said Catherine M. Said Lisa James William A. Sparrow Rezaul Begg |
| author_sort | Hanatsu Nagano |
| collection | DOAJ |
| description | Increased falls risk is prevalent among stroke survivors with gait impairments. Tripping is the leading cause of falls and it is highly associated with mid-swing Minimum Foot Clearance (MFC), when the foot’s vertical margin from the walking surface is minimal. The current study investigated MFC characteristics of post-stroke individuals (n = 40) and healthy senior controls (n = 21) during preferred speed treadmill walking, using an Optotrak 3D motion capture system to record foot-ground clearance. In addition to MFC, bi-lateral spatio-temporal gait parameters, including step length, step width and double support time, were obtained for the post-stroke group’s Unaffected and Affected limb and the control group’s Dominant and Non-dominant limbs. Statistical analysis of MFC included central tendency (mean, median), step-to-step variability (standard deviation and interquartile range) and distribution (skewness and kurtosis). In addition, the first percentile, that is the lowest 1% of MFC values (MFC 1%) were computed to identify very high-risk foot trajectory control. Spatio-temporal parameters were described using the mean and standard deviation with a 2 × 2 (Group × Limb) Multivariate Analysis of Variance applied to determine significant Group and Limb effects. Pearson’s correlations were used to reveal any interdependence between gait variables and MFC control. The main finding of the current research was that post-stroke group’s affected limb demonstrated lower MFC 1% with higher variability and lower kurtosis. Post-stroke gait was also characterised by shorter step length, larger step width and increased double support time. Gait retraining methods, such as using real-time biofeedback, would, therefore, be recommended for post-stroke individuals, allowing them to acquire optimum swing foot control and reduce their tripping risk by elevating the swing foot and improving step-to-step consistency in gait control. |
| first_indexed | 2024-12-20T00:52:58Z |
| format | Article |
| id | doaj.art-f2f5cec0397e496ca2b77f4fa35bbbfb |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-20T00:52:58Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-f2f5cec0397e496ca2b77f4fa35bbbfb2022-12-21T19:59:12ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-03-011310.3389/fphys.2022.833417833417Biomechanical Correlates of Falls Risk in Gait Impaired Stroke SurvivorsHanatsu Nagano0Catherine M. Said1Catherine M. Said2Catherine M. Said3Catherine M. Said4Lisa James5William A. Sparrow6Rezaul Begg7Institute for Health and Sports (IHeS), Victoria University, Melbourne, VIC, AustraliaDepartment of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC, AustraliaDepartment of Physiotherapy, Western Health, St. Albans, VIC, AustraliaAustralian Institute for Musculoskeletal Science, St. Albans, VIC, AustraliaDepartment of Physiotherapy, Austin Health, Heidelberg, VIC, AustraliaInstitute for Health and Sports (IHeS), Victoria University, Melbourne, VIC, AustraliaInstitute for Health and Sports (IHeS), Victoria University, Melbourne, VIC, AustraliaInstitute for Health and Sports (IHeS), Victoria University, Melbourne, VIC, AustraliaIncreased falls risk is prevalent among stroke survivors with gait impairments. Tripping is the leading cause of falls and it is highly associated with mid-swing Minimum Foot Clearance (MFC), when the foot’s vertical margin from the walking surface is minimal. The current study investigated MFC characteristics of post-stroke individuals (n = 40) and healthy senior controls (n = 21) during preferred speed treadmill walking, using an Optotrak 3D motion capture system to record foot-ground clearance. In addition to MFC, bi-lateral spatio-temporal gait parameters, including step length, step width and double support time, were obtained for the post-stroke group’s Unaffected and Affected limb and the control group’s Dominant and Non-dominant limbs. Statistical analysis of MFC included central tendency (mean, median), step-to-step variability (standard deviation and interquartile range) and distribution (skewness and kurtosis). In addition, the first percentile, that is the lowest 1% of MFC values (MFC 1%) were computed to identify very high-risk foot trajectory control. Spatio-temporal parameters were described using the mean and standard deviation with a 2 × 2 (Group × Limb) Multivariate Analysis of Variance applied to determine significant Group and Limb effects. Pearson’s correlations were used to reveal any interdependence between gait variables and MFC control. The main finding of the current research was that post-stroke group’s affected limb demonstrated lower MFC 1% with higher variability and lower kurtosis. Post-stroke gait was also characterised by shorter step length, larger step width and increased double support time. Gait retraining methods, such as using real-time biofeedback, would, therefore, be recommended for post-stroke individuals, allowing them to acquire optimum swing foot control and reduce their tripping risk by elevating the swing foot and improving step-to-step consistency in gait control.https://www.frontiersin.org/articles/10.3389/fphys.2022.833417/fullstrokefalls preventiongait retrainingtripping preventminimum foot clearance |
| spellingShingle | Hanatsu Nagano Catherine M. Said Catherine M. Said Catherine M. Said Catherine M. Said Lisa James William A. Sparrow Rezaul Begg Biomechanical Correlates of Falls Risk in Gait Impaired Stroke Survivors Frontiers in Physiology stroke falls prevention gait retraining tripping prevent minimum foot clearance |
| title | Biomechanical Correlates of Falls Risk in Gait Impaired Stroke Survivors |
| title_full | Biomechanical Correlates of Falls Risk in Gait Impaired Stroke Survivors |
| title_fullStr | Biomechanical Correlates of Falls Risk in Gait Impaired Stroke Survivors |
| title_full_unstemmed | Biomechanical Correlates of Falls Risk in Gait Impaired Stroke Survivors |
| title_short | Biomechanical Correlates of Falls Risk in Gait Impaired Stroke Survivors |
| title_sort | biomechanical correlates of falls risk in gait impaired stroke survivors |
| topic | stroke falls prevention gait retraining tripping prevent minimum foot clearance |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2022.833417/full |
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