Gait Characteristics at Different Speeds in Individuals With Stroke

Overview

Stroke is the second leading cause of death and the third leading cause of death combined with disability worldwide. Despite improved recognition and management of stroke risk factors, the risk of stroke has increased by 50% in the last two decades due to increased life expectancy, currently affecting one in every four individuals. If this trend continues, by 2030, it is estimated that 12 million people will die from stroke, and 70 million will live with its consequences. Stroke leads to significant changes in the spatiotemporal parameters of gait. Spatial parameters include step length, stride length, and step width, while temporal parameters comprise cadence, stance phase, double support phase (DSP), and swing phase. Gait speed, incorporating both spatial and temporal elements, is classified as a spatiotemporal parameter. Compared to healthy individuals, people post-stroke tend to have increased DSP and stance phases, shortened step lengths, and widened step widths. Asymmetries between the paretic and non-paretic limbs further disrupt gait symmetry. Previous studies have shown that during prolonged walking tasks such as the 6-minute walk test, both gait speed and symmetry deteriorate in the later stages, potentially due to fatigue. However, changes in walking speed itself may also influence gait symmetry. From this perspective, the aim of this study is to investigate how spatiotemporal gait parameters vary across different walking speeds in individuals with stroke.

Stroke is one of the leading causes of death and disability worldwide, with increasing prevalence due to longer life expectancy, despite improved recognition and management of risk factors. Stroke-related impairments, particularly in gait, significantly affect individuals' independence and quality of life. Post-stroke gait is commonly characterized by altered spatiotemporal parameters, including reduced step length, increased double support phase, asymmetry between paretic and non-paretic limbs, and reduced walking speed. This descriptive study aims to investigate how different walking speeds affect the spatiotemporal gait parameters in individuals with stroke. Specifically, the study will examine walking at comfortable, slow (-25%), and fast (+25%) speeds using an instrumented treadmill (C-Mill). The target population includes adult individuals (18+) diagnosed with hemiplegia (ICD-10: G81), who are able to ambulate with or without assistance (Functional Ambulation Classification ≥2). Spatiotemporal gait parameters, including step length, step width, cadence, stance and swing phases, and double support time, will be collected for both paretic and non-paretic limbs. These parameters will be assessed at three different walking speeds. In addition to gait analysis, functional status will be evaluated using the Functional Ambulation Classification (FAC), Berg Balance Scale (BBS), and the lower extremity section of the Fugl-Meyer Assessment (FMA-LE). Demographic and clinical information will also be recorded. Participants will first walk at their comfortable speed to familiarize themselves with the treadmill and to determine baseline parameters. After a 2-minute warm-up walk, a 2-minute data collection phase will follow. The same procedure will be repeated at the slow and fast walking speeds. Gait symmetry and changes in temporal-spatial parameters across walking speeds will be analyzed to explore the influence of speed variation, particularly regarding the mechanisms underlying gait asymmetry and fatigue. This research will provide insight into how walking speed modulates gait parameters in stroke survivors and may contribute to developing more targeted gait training strategies in neurorehabilitation.