title: The effect of stroke on foot kinematics and the functional consequences.
abstract: BACKGROUND
  Although approximately one-third of stroke survivors suffer abnormal foot posture and this can influence mobility, there is very little objective information regarding the foot and ankle after stroke.
  
  
  OBJECTIVE
  As part of a programme of research examining foot and ankle biomechanics after stroke, we investigated multi-planar kinematics and the relationship with function.
  
  
  METHODS
  In a single assessment session, static foot posture (Foot Posture Index); mobility limitations (Walking Handicap Scale) and multi-segment foot and ankle kinematics during stance phase of walking were measured in 20 mobile chronic stroke survivors and 15 sex and age-matched healthy volunteers.
  
  
  RESULTS
  Compared to the healthy volunteers, the stroke survivors demonstrated consistently reduced range of motion across most segments and planes, increased pronation and reduced supination, disruption of the rocker and the timing of joint motion. Changes in pronation/supination were associated with limited walking ability.
  
  
  CONCLUSIONS
  This study provides evidence of structural and movement deficiencies in the intrinsic foot segments affected by stroke. These would not have been detectable using a single segment foot model. Data do not support common clinical practices that focus on correction of sagittal ankle deformity and assumed excessive foot supination. Some of these abnormalities were associated with limitation in functional ability. Biomechanical abnormalities of foot and ankle are modifiable and there is potential for clinical studies and future developments of interventions to help prevent or treat these abnormalities which may improve functional ability post stroke.
authors.affiliation: Centre for Health Sciences Research, University of Salford, UK; Musculoskeletal Research Centre, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Iran. Electronic address: saeed_forghany@rehab.mui.ac.ir.
authors.forename: Saeed
authors.initials: S
authors.lastname: Forghany
authors.affiliation: Centre for Health Sciences Research, University of Salford, UK.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Nester
authors.affiliation: Centre for Health Sciences Research, University of Salford, UK; Stroke Research Centre, School of Nursing Midwifery and Social Work, University of Manchester, UK.
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Tyson
authors.affiliation: Centre for Health Sciences Research, University of Salford, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Preece
authors.affiliation: Centre for Health Sciences Research, University of Salford, UK.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Jones
mesh_terms: D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology; D001696:Biomechanical Phenomena / Q000502:physiology; D016022:Case-Control Studies; D005528:Foot / Q000503:physiopathology*; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D011403:Pronation / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D012044:Regression Analysis; D020521:Stroke / Q000503:physiopathology*; D013484:Supination / Q000502:physiology; D016138:Walking / Q000502:physiology*
keywords: Ankle; Biomechanics; Foot joints; Mobility; Stroke