Changes in Walking Speed After High-Intensity Treadmill Training Are Independent of Changes in Spatiotemporal Symmetry After Stroke

The Association of Interlimb Coordination and Temporal Symmetry With Walking Function and Motor Impairment After Stroke

OBJECTIVE

Interlimb coordination during walking is impaired after stroke, with unknown effects on walking function. This cross-sectional study determined associations of interlimb coordination and temporal symmetry with walking function and motor impairment.

DESIGN

During walking, participants wore wireless sensors to detect heel strikes. We calculated interlimb coordination as the phase coordination index and temporal symmetry as the ratio of contralesional (i.e., paretic) to ipsilesional (i.e., nonparetic) stance times. Associations with walking speed (10-meter walk test), walking endurance (6-min walk test), dynamic balance (Mini-Balance Evaluation Systems Test), and motor impairment (Fugl-Meyer Lower Extremity assessment) were assessed.

RESULTS

Fifty-six individuals with chronic stroke were tested. Worse interlimb coordination was correlated with slower comfortable ( R = -0.38, P = 0.004) and maximal ( R = -0.36, P = 0.006) walking speed and worse motor function ( R = -0.45, P = 0.001). Worse temporal symmetry was correlated with worse motor function ( R = 0.39, P = 0.004). Interlimb coordination had stronger associations than temporal symmetry with comfortable ( R = -0.38 vs. 0.08) and maximal walking speeds ( R = -0.36 vs. 0.12).

CONCLUSIONS

Poor interlimb coordination was associated with slow walking and motor impairment and had stronger associations with walking speeds than temporal symmetry did. Interlimb coordination may provide unique insights into walking function and a target for walking rehabilitation after stroke.