Over-ground walking on level and sloped surfaces in people with stroke compared to healthy matched adults

Disabil Rehabil. 2013 Jul;35(15):1302-7. doi: 10.3109/09638288.2012.729646. Epub 2012 Dec 5.


Purpose: To investigate the basic spatio-temporal gait characteristics of people with stroke whilst walking on sloped and level terrain, and to compare this performance to healthy matched adults.

Method: Fifteen community dwelling people with stroke who walked with a hemiplegic gait and a reference group of 15 adults without impairments matched for sex, age and height participated in this descriptive, observational study. Basic gait spatio-temporal measures were recorded at self-selected speed across a GAITRite mat placed on level, uphill and downhill (ramp gradient 1:14 or 4.1°) surfaces. Measures recorded were gait speed, cadence, step length, support base, single and double limb support duration and step length symmetry. Group and walking condition effects were assessed by two separate 2-way (group × slope) repeated measures multivariate analysis of variance.

Results: The stroke group walked slower (p < 0.001) than the reference group for all conditions. Within-group analyses found the stroke group decreased their speed and step length when walking downhill compared to level and uphill walking (p < 0.001). In contrast, the reference group maintained speed across all walking conditions.

Conclusions: The findings suggest that walking on slopes affects gait speed in people with stroke and this may have implications when walking in the community.

Implications for rehabilitation: • Although a high percentage of people achieve walking independence following a stroke, few achieve independent community mobility. • Walking on slopes is an important aspect of community mobility. • When walking down a standard gradient ramp, people with stroke reduced their speed and step length, relative to level over-ground and uphill walking. • It is recommended that attention be directed to assessment and treatment of walking on slopes as part of stroke rehabilitation, as this may have implications when walking in the community.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Case-Control Studies
  • Exercise Test / methods*
  • Female
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / rehabilitation*
  • Gait*
  • Geriatric Assessment / methods*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postural Balance / physiology
  • Stroke / complications
  • Stroke Rehabilitation*
  • Walking / physiology*