ASYMMETRY OF GAIT INITIATION IN HEMIPARETIC STROKE SUBJECTS

Objective: To investigate symmetry of gait initiation in healthy and h emiparetic subjects. Design: Survey Setting: Kinematic laboratory affi liated with a hospital-based department of rehabilitation Patients or Other Participants: Ten healthy and 14 hemiparetic stroke subjects sta rting five times with their right and left leg, respectively. Main Out come Measures: Duration of defined periods, step length, center of pre ssure, and center of mass were recorded and calculated using two triax ial force plates, contact switches, and a video camera system. Results : Healthy subjects displayed a high degree of independence of kinetic and kinematic parameters of the starting limb. Hemiparetic patients sh owed differences with respect to the starting limb: when starting with the nonaffected leg, the swing period and step length was shorter and the center of pressure displayed a more marked medio-lateral sway wit h no corresponding initial movement of the center of mass; when starti ng with the affected leg the movement pattern of the center of pressur e and center of mass was comparable to that of normal subjects. Conclu sions: The trajectories of the center of pressure and center of mass a nd the symmetry parameters are in accordance with a higher degree of u ncertainty when starting with the nonaffected limb in hemiparetic subj ects. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.