Analysis of gait pattern deviations among chronic post stroke patients

Objective: To determine the abnormalities of different parameters of gait and to determine the association of spasticity with them in chronic post stroke population. Methodology: It was a cross sectional descriptive study conducted over a duration of 3 months in 2017 at Pakistan Institute of Medical Sciences, Islamabad and Railway General Hospital, Rawalpindi and included 104 chronic stroke patients using non probability purposive sampling technique. Patients presenting with both ischemic and hemorrhagic stroke, both genders having age of 25 year to 75 years, patients who had suffered from stroke in past 6 months at time of data collection were included in the study. Those patients who had weakness due to any tumor, Gullian Barre Syndrome, peripheral nerve injury, multiple sclerosis or traumatic brain injury were excluded from the study. Dynamic gait index, Modified Ashworth scale, 10 meter walk test and temporospatial characteristics like, step length, stride length, step width and cadence were used as data collection tools. Data analysis was performed by SPSS version 21. Results: The mean age of patients was 55.56 +/- 13.46 years. Marked gait deviations were observed including decreased step length (12.75 +/- 2.23) inches, stride length (22.99 +/- 4.11) inches, cadence (66.92 +/- 20.31) steps/min and increased step width (8.15 +/- 1.58) inches. Increased tone in lower limb muscles was found in the patients on modified Ashworth scale and decreased gait velocity by 10 meter walk test (0.49 +/- 0.23) m/s. Greater risk of fall was observed by dynamic gait index (13.5 +/- 5.22). Conclusion: There were marked deviations of gait in post stroke population in chronic stage. These included changes in step length, stride length, step width and cadence. There were also changes in the scores of dynamic gait index and 10 meter walk test which showed an alteration in gait speed and adaptability thus limiting the independence of stroke patients.