title: Spatial-temporal gait variability poststroke: variations in measurement and implications for measuring change.
abstract: OBJECTIVE
  To determine the responsiveness to change of spatial-temporal gait parameters among stroke survivors for 3 different variability measures: SD, coefficient of variation (CV), and median absolute deviation (MAD).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Clinical laboratory in a Canadian hospital.
  
  
  METHODS
  Stroke survivors (N=74) receiving inpatient rehabilitation.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Spatial-temporal gait variability was calculated for step length, step width, stance time, swing time, and double support time. Responsiveness to change was determined by comparing (1) trials without versus trials with a concurrent cognitive task and (2) admission to discharge from rehabilitation.
  
  
  RESULTS
  Variability estimators (SD, CV, and MAD) increased with the addition of a cognitive task and decreased from admission to discharge of rehabilitation. However, these changes were not statistically significant when change in gait velocity was included as a covariate. The effect size values were similar for all variability estimators with a trend toward a greater SD response to temporal parameters. The CV displayed a larger response to change for step length than did the SD and MAD. Although gait variability decreased between admission and discharge, the effect size was larger for the condition without the cognitive task than for the condition with the cognitive task.
  
  
  CONCLUSIONS
  Our results show that gait variability estimators demonstrate a similar responsiveness to a concurrent cognitive task and improved walking ability with recovery from stroke. Future work may focus on evaluating the clinical utility of these measures in relation to informing therapy and response to gait-specific training protocols.
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada. Electronic address: achisholm@icord.org.
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Chisholm
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
authors.forename: Shelley
authors.initials: S
authors.lastname: Makepeace
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Inness
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada; Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Perry
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada; Heart & Stroke Foundation, Centre for Stroke Recovery, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: William E
authors.initials: WE
authors.lastname: McIlroy
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada; Heart & Stroke Foundation, Centre for Stroke Recovery, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Avril
authors.initials: A
authors.lastname: Mansfield
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D004185:Disability Evaluation; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation
keywords: Hemiplegic gait; Rehabilitation; Stroke