Gait Deviation Associated with Absent Terminal Stance Phase in People with Stroke

Purpose The purpose of this study was to identify gait deviations during the four rocker phases of gait cycle in people with stroke compared to healthy adults. Methods Fourteen communitydwelling stroke subjects (9 males, 5 females) with unilateral hemiparesis and fifteen healthy adults (10 females, 5 males) had video recording as they walked a fivemeter walkway to analyze the four phases of the gait cycle (loading response, midstance, terminal stance, and preswing). Subjects performed the five times sit to stand (5STS) test to measure the severity of strength and balance deficits. The distance and time for the four phases and the speed of steady state of walking were measured using a movement analysis software (Dartfish ProSuite 9). This study used the multivariate analysis of variance technique with one fixed factor (group) to identify the multivariate effect of distance, time, and speed related to four consecutive phases. Results The distance and time of the four consecutive phases of gait were significantly different in stroke subjects compared to healthy subjects (p< 0.05). Specifically, the forefoot rocker, or terminal stance phase, was absent in all stroke subjects which increased their double limb support time resulting in slow gait speed compared to the healthy control group (p< 0.05). Conclusions People with stroke demonstrated reduced body forward progression over four rocker phases compared to the healthy control during a steady state of walking. The ratio of the four rocker phases can be used to specify the gait deviation for clinicians to improve post stroke hemiplegic gait.