Understanding Spatial and Temporal Gait Asymmetries in Individuals Post Stroke
- *Corresponding Author:
- Sylvie Nadeau
Professeure titulaire, Ecole de Réadaptation
Faculté de médecine
Université de Montréal, C.P.6128 Succ. Centre-ville
Montréal QC, Canada
Tel: (514) 343-2253
Fax: (514) 343-2105
E-mail: [email protected]
Received Date: April 01, 2014; Accepted Date: May 20, 2014; Published Date: May 23, 2014
Citation: Lauziere S, Betschart M, Aissaoui R, Nadeau S (2014) Understanding Spatial and Temporal Gait Asymmetries in Individuals Post Stroke. Int J Phys Med Rehabil 2:201. doi: 10.4172/2329-9096.1000201
Copyright: © 2014 Lauziere S et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Gait asymmetry in spatial and temporal parameters and its impacts on functional activities have always raised many interesting questions in research and rehabilitation. The aim of this topical review is threefold: 1) to examine different equations of asymmetry of gait parameters and make recommendations for standardization, 2) to deepen the understanding of the relationships between sensorimotor deficits, spatiotemporal (step length, swing time and double support time) and biomechanical (kinematic, kinetic, muscular activity) parameter asymmetries during gait and, 3) to summarize the impacts of gait asymmetry on walking speed, falls, and energy cost in individuals post stroke. In light of current literature, we recommend quantifying spatiotemporal asymmetries by calculating symmetry ratios. However, for other gait parameters (such as kinetic or kinematic data), the choice will depend on the variability of the data and the objective of the study. Regardless of the selected asymmetry equation, we recommend presenting the asymmetry values in combination with the mean value of each side to facilitate comparisons between studies. This review also revealed that sensorimotor deficits clinically measured are not sufficient to explain the large variability of spatiotemporal asymmetries (particularly for step length and double support time) in individuals post stroke. Biomechanical analysis has been identified as a relevant approach to understanding gait deviations. Studies that linked biomechanical impairments to spatiotemporal asymmetries suggest that a balance issue and an impaired paretic forward propulsion could be among the important factors underlying spatiotemporal asymmetries. In our opinion, this paper provides meaningful information to aid in better understanding gait deviations in persons after stroke and establishes the need for future studies regrouping individuals post stroke according to their spatiotemporal asymmetries. Furthermore, further studies targeting efficacy of locomotor rehabilitation and the impacts of gait asymmetry on risk of falls and energy expenditure are needed.