Accelerometric assessment of different dimensions of natural walking during the first year after stroke: Recovery of amount, distribution, quality and speed of walking
Marina Castel Sánchez , Johannes Bussmann, Wim Janssen, Herwin Horemans, Sebastian Chastin, Majanka Heijenbrok, Henk Stam
Physical Therapy, Seville University, 41009 Seville, Spain. E-mail: firstname.lastname@example.org
Objectives: To describe the course of walking behaviour over a period of 1 year after stroke, using accelerometry, and to compare 1-year data with those from a healthy group.
Design: One-year follow-up cohort study.
Subjects: Twenty-three stroke patients and 20 age-matched healthy subjects.
Methods: Accelerometer assessments were made in the participants’ daily environment for 8 h/day during the 1st (T1), 12th (T2) and 48th (T3) weeks after stroke, and at one time-point in healthy subjects. Primary outcomes were: percentage of time walking and upright (amount); mean duration and number of walking periods (distribution); step regularity and gait symmetry (quality); and walking speed.
Results: Time walking, time upright, and number of walking bouts increased during T1 and T2 (p < 0.01) and then levelled off (p > 0.30). Mean duration of walking periods showed no significant improvements (p > 0.30) during all phases. Step regularity, gait symmetry and gait speed showed a tendency to increase consistently from T1 to T3. At T3, amount and distribution variables reached the level of the healthy group, but significant differences remained (p < 0.02) in step regularity and gait speed.
Conclusion: In this cohort, different outcomes of walking behaviour showed different patterns and levels of recovery, which supports the multi-dimensional character of gait.
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