Control of lead and trail limbs during obstacle crossing following stroke.
OBJECTIVE
Obstacle crossing is compromised following stroke. The purpose of this study was to quantify modifications during obstacle clearance following stroke.


METHODS
Twelve subjects with stroke and 12 subjects without stroke participated in the study.


METHODS
Kinematic variables were measured while participants crossed a 4-cm-high obstacle. Subjects with stroke walked at a self-selected speed; subjects without stroke walked at a comparable speed and at a self-selected speed.


RESULTS
Several modifications were observed following stroke with both groups walking at self-selected speeds. The affected lead limb was positioned closer to the obstacle before crossing. Affected trail-limb clearance over the obstacle was reduced. Both affected and unaffected lead and trail limbs landed closer to the obstacle after clearance. Swing time was increased in the affected lead limb after obstacle clearance. Fewer modifications were detected at matched walking speed; the trail limb still landed closer to the obstacle.


CONCLUSIONS
Modifications during obstacle crossing following stroke may be partly related to walking speed. The findings raise issues of safety because people with stroke demonstrated reduced clearance of a 4-cm obstacle and limb placement closer to the obstacle after clearance.
Said
Catherine M
CM
Physiotherapy Department, Allied Health Treatment Centre, Level 3, Flanders Wing, Heidelberg Repatriation Hospital, Austin Health, PO Box 5444, Heidelberg West, 3084 Victoria, Australia. Cathy.Said@austin.org.au
Goldie
Patricia A
PA
Culham
Elsie
E
Sparrow
William A
WA
Patla
Aftab E
AE
Morris
Meg E
ME
D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012984:Software; D020521:Stroke / Q000503:physiopathology*; D016138:Walking / Q000502:physiology*