The relationship between lower limb coordination and walking speed following stroke: an observational study

Abstract

THE RELATIONSHIP BETWEEN LOWER LIMB COORDINATION AND WALKING SPEED FOLLOWING STROKE: AN OBSERVATIONAL STUDY Even after recovery of strength, many people with stroke walk slowly, and this may be the result of poor lower limb coordination. The broad aim of the project was to investigate the contribution of loss of coordination to walking disability after stroke. The main research question was ‘Is decreased lower limb coordination related to slow walking speed in people who have regained lower limb strength after stroke?’ An observational study was conducted including 30 people after stroke and 30 healthy controls. Inclusion criteria for stroke participants were lower limb strength (i.e. ≥ Grade 4) and walking speed > 0.6 m/s unaided and in bare feet (stratified so that walking speed was evenly represented across the range of 0.6 to >1.2 m/s). Walking speed was measured using 10m walk test and 6-minute walk test and reported in m/s. Coordination was measured using the Lower Extremity Motor Coordination Test (LEMOCOT) and reported in taps/s. The stroke participants were tested on average 25 months (SD 30) after stroke, walked at 1.00 (SD 0.26) m/s in the 10-m walk test, and performed the LEMOCOT on affected side at 1.20 (SD 0.34) taps/s. The healthy controls walked at 1.57 (SD 0.31) m/s in the 10-m walk test, and performed the LEMOCOT on non-dominant side at 1.85 (SD 0.36) taps/s. LEMOCOT scores for both sides of the stroke group were significantly correlated with walking speed (r = 0.42 to 0.51, p<0.05). People with stroke were operating at about 2/3 of their age-matched counterparts in both LEMOCOT and walking speed. In the stroke group with well-recovered strength, coordination was strongly related to walking speed, suggesting that loss of coordination may contribute to slow walking. These findings suggest that once people after stroke have regained sufficient strength to walk at reasonable speeds, intervention targeting coordination may produce faster walking.