title: Determinants of limb preference for initiating compensatory stepping poststroke.
abstract: OBJECTIVE
  To investigate the determinants of limb preference for initiating compensatory stepping poststroke.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Inpatient rehabilitation.
  
  
  METHODS
  Convenience sample of individuals admitted to inpatient rehabilitation with poststroke hemiparesis.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Compensatory stepping responses were evoked using a lean-and-release postural perturbation. The limb used to initiate compensatory stepping was determined. The relationships between stepping with the paretic limb and premorbid limb dominance, weight bearing on the paretic limb in quiet standing, ability to bear weight on the paretic limb, preperturbation weight bearing on the paretic limb, and lower-limb motor recovery scores were determined.
  
  
  RESULTS
  The majority (59.1%) of responses were steps initiated with the nonparetic limb. Increased lower-limb motor recovery scores and preperturbation weight bearing on the nonparetic limb were significantly related to increased frequency of stepping with the paretic limb. When the preferred limb was physically blocked, an inappropriate response was initiated in 21% of trials (ie, nonstep responses or an attempt to step with the blocked limb).
  
  
  CONCLUSIONS
  This study reveals the challenges that individuals with poststroke hemiparesis face when executing compensatory stepping responses to prevent a fall after a postural perturbation. The inability or challenges to executing a compensatory step with the paretic limb may increase the risk for falls poststroke.
authors.affiliation: Heart and Stroke Foundation Centre for Stroke Recovery, Toronto, ON, Canada. avril.mansfield@utoronto.ca
authors.forename: Avril
authors.initials: A
authors.lastname: Mansfield
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Inness
authors.forename: Bimal
authors.initials: B
authors.lastname: Lakhani
authors.forename: William E
authors.initials: WE
authors.lastname: McIlroy
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000222:Adaptation, Physiological; D015331:Cohort Studies; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D057240:Patient Preference; D004856:Postural Balance / Q000502:physiology*; D011930:Reaction Time; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology