Journal Club CEU Approval
Contact Hours: 1
AR | FL CE26-803266 | ID
Individuals poststroke do not perceive their spatiotemporal gait asymmetries as abnorma
JC15Q4
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Webinar Description
Wutzke CJ, Faldowski RA, Lewek MD (2015). Individuals poststroke do not perceive their spatiotemporal gait asymmetries as abnormal. Phys Ther 95(9):1244-53 Introduction: This observational study examined the reason for persistent gait asymmetry in stroke survivors despite the higher energy cost, slower speed, and poorer safety associated with gait asymmetry. The ability to produce a symmetric gait pattern following split-belt treadmill training implies that individuals with hemiplegia can produce symmetrical gait, but they do not do so on a regular basis. The authors had participants with hemiplegia post-stroke identify asymmetrical treadmill belt speeds while walking on a split-belt treadmill, and found that both spatial (step length) and temporal (stance time) asymmetry ratios needed exceed their usual over ground magnitudes in order to reach conscious awareness. The results of this study suggest that participants were unaware of their asymmetric gait despite its persistence in their everyday life. Perception of asymmetric gait as “normal” would not compel them to change their established pattern. The threshold of awareness of asymmetry was greater in this population of people post stroke than in older adults without impairments, indicating that gait asymmetry may be perceived as normal in stroke survivors, thus explaining its persistence despite the ability to generate symmetrical gait patterns when imposed (e.g. by split-belt treadmill). This is supported by study findings correlating presence of gait asymmetry over ground with greater awareness thresholds for spatiotemporal asymmetry. Treatment approaches that target this perceptual deficit related to movement errors may successfully alter movement patterns in stroke survivors, while robotic and other treatment protocols that minimize movement errors may not be perceived as different from a patient’s typical movement pattern, providing little impetus to maintain the corrected movement pattern: therefore it may not persist long-term. Minimizing asymmetry in a passive manner may be less effective in learning a new symmetric pattern.
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Webinar Information
Contact Hours: 1
Price: $10
Instructor: Nechama Karman
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