title: Stability and Harmony of Gait in Patients with Subacute Stroke.
abstract: Stroke affects many gait features, such as gait stability, symmetry, and harmony. However, it is still unclear which of these features are directly altered by primary damage, and which are affected by the reduced walking speed. The aim of this study was to analyze the above gait features in patients with subacute stroke with respect to the values observed in age- and speed-matched healthy subjects. A wearable triaxial accelerometer and an optoelectronic device were used for assessing the upright gait stability, symmetry of trunk movements, and harmonic structure of gait phases by means of the root-mean-square (RMS) acceleration of the trunk, harmonic ratio (HR), and gait ratios (GRs), respectively. For healthy subjects, results showed that RMS acceleration increased with speed, HR peaked at a comfortable speed, and GRs tended towards the theoretical value of the golden ratio for speeds >1 m/s. At matched speed conditions, patients showed higher instabilities in the latero-lateral axis (p= 0.001) and reduced symmetry of trunk movements (p= 0.002). Different from healthy subjects, antero-posterior and latero-lateral acceleration harmonics were coupled in patients (R = 0.507,p= 0.023). Conversely, GRs were not more altered in patients than in slow-walking healthy subjects. In conclusion, patients with stroke showed some characteristics similar to those of the elderly when the latter subjects walk slowly, and some altered characteristics, such as increased latero-lateral instabilities coupled with movements performed along the antero-posterior axis.
authors.affiliation: IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Iosa
authors.affiliation: Aerospace and Mechanical Engineering Department, Sapienza University of Rome, 00184 Rome, Italy.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Bini
authors.affiliation: Aerospace and Mechanical Engineering Department, Sapienza University of Rome, 00184 Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Marinozzi
authors.affiliation: IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Fusco
authors.affiliation: IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morone
authors.affiliation: IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy ; Stroke Unit, Policlinico Tor Vergata, 00133 Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Koch
authors.affiliation: IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Alex
authors.initials: A
authors.lastname: Martino Cinnera
authors.affiliation: IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Bonnì
authors.affiliation: IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Paolucci
keywords: Accelerometry; Ambulation; Balance; Biomechanics; Golden ratio; Rehabilitation; Walking