Effect of stroke on step characteristics of obstacle crossing

Objective: To compare spatial and temporal measures during lead limb obstac le crossing between subjects with stroke and healthy, subjects. Design: Experimental, observational, with matched controls. Setting: Geriatric rehabilitation unit in a tertiary referral hospital. Participants: Distance data were available for 19 subjects with stroke and 19 able-bodied subjects. Temporal data were available for 16 subjects with stroke and 16 able-bodied subjects. Subjects with stroke were inpatients an d had to be able to walk 10 meters without assistance or gait aid. Intervention: Subjects were required to step over high and wide obstacles, ranging from 1 to 8cm, and trials were videotaped. Main Outcome Measures: Toe clearance, preobstacle distance, postobstacle di stance, step length, proportion of step length preobstacle, step time, preo bstacle step time, postobstacle step time, and proportion of step time preo bstacle were measured. Results: Mann-Whitney U tests were performed to determine differences betwe en the 2 groups. Subjects with stroke had significantly higher toe clearanc e, smaller postobstacle distances, and greater step times than healthy subj ects. Subjects with stroke did not demonstrate a significant reduction in p reobstacle distance. Conclusion: By modifying their lead limb trajectory during obstacle crossin g, persons with stroke reduce the risk of a trip due to toe contact, but th e modification may expose them to other safety risks.