title: Gait reveals bilateral adaptation of motor control in patients with chronic unilateral stroke.
abstract: OBJECTIVE
  Functional brain imaging has shown that bilateral brain reorganization may occur after unilateral cerebral damage. The present study searched for evidence of bilateral motor control changes in gait in patients with chronic unilateral stroke.
  
  
  METHODS
  Gait variables (temporal and spatial parameters, footprint peak times (FPPT) and footfall times (FFT)) were recorded in 48 patients with chronic unilateral stroke at their preferred speed, and in 10 healthy volunteers walking from very slowly to very fast on a pressure sensor walkway. The data were divided into 4 groups according to gait velocity. The functional outcome of stroke was measured by the Barthel Index.
  
  
  RESULTS
  Patients' gait variables reflected their hemiparetic gait pattern. Slower patients had prolonged stance, FPPT and FFT on the non-affected side (NS), and prolonged swing and shorter FPPT and FFT on the affected side (AS). The magnitude of the asymmetry index of these parameters was inversely associated with velocity performance and, at the same time, it characterized how much the control of the clinically healthy (NS) side was altered during walking. Bilateral changes in kinetic and footfall variables in the chronic stage of unilateral stroke were present.
  
  
  CONCLUSIONS
  Patients chose their preferred walking velocity using stereotyped, alternative gait patterns, in which the contribution of the NS was larger than that of the AS. Alternative gait patterns may partly demonstrate compensatory behavioral strategies adapted by patients.
authors.affiliation: Department of Neurology and Neurosurgery, Military Medical Academy, Sofia, Bulgaria.
authors.forename: Ekaterina B
authors.initials: EB
authors.lastname: Titianova
authors.forename: Sinikka H
authors.initials: SH
authors.lastname: Peurala
authors.forename: Kauko
authors.initials: K
authors.lastname: Pitkänen
authors.forename: Ina M
authors.initials: IM
authors.lastname: Tarkka
mesh_terms: D000222:Adaptation, Physiological; D000704:Analysis of Variance; D001921:Brain / Q000503:physiopathology; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000150:complications / Q000503:physiopathology; D002544:Cerebral Infarction / Q000150:complications / Q000503:physiopathology; D002908:Chronic Disease; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology; D020521:Stroke / Q000150:complications / Q000503:physiopathology*