Title

Assessment of backward walking unmasks mobility impairments in post-stroke community ambulators

Document Type

Article

Publication Date

7-4-2019

Subject Area

ARRAY(0x55b6a60d6c98)

Abstract

Background: While over half of stroke survivors recover the ability to walk without assistance, deficits persist in the performance of walking adaptations necessary for safe home and community mobility. One such adaptation is the ability to walk or step backward. Post-stroke rehabilitation rarely includes backward walking (BW) assessment and BW deficits have not been quantified in post-stroke community ambulators. Objective: To quantify spatiotemporal and kinematic BW characteristics in post-stroke community ambulators and compare their performance to controls. Methods: Individuals post-stroke (n = 15, 60.1 ± 12.9 years, forward speed: 1.13 ± 0.23 m/s) and healthy adults (n = 12, 61.2 ± 16.2 years, forward speed: 1.40 ± 0.13 m/s) performed forward walking (FW) and BW during a single session. Step characteristics and peak lower extremity joint angles were extracted using 3D motion analysis and analyzed with mixed-method ANOVAs (group, walking condition). Results: The stroke group demonstrated greater reductions in speed, step length and cadence and a greater increase in double-support time during BW compared to FW (p <.01). Compared to FW, the post-stroke group demonstrated greater reductions in hip extension and knee flexion during BW (p <.05). The control group demonstrated decreased plantarflexion and increased dorsiflexion during BW, but these increases were attenuated in the post-stroke group (p <.05). Conclusions: Assessment of BW can unmask post-stroke walking impairments not detected during typical FW. BW impairments may contribute to the mobility difficulties reported by adults post-stroke. Therefore, BW should be assessed when determining readiness for home and community ambulation.

Publication Title

Topics in Stroke Rehabilitation

Volume

26

Issue

5

First Page

382

Last Page

388

Digital Object Identifier (DOI)

10.1080/10749357.2019.1609182

PubMed ID

31081491

ISSN

10749357

E-ISSN

19455119

Share

COinS