Stance Phase Kinematics in Ankle Joint during Ambulation on Uneven Surface: A Comparison between Stroke Survivors and Typical Adults

Abstract

Purpose: Gait impairment is a common disability among stroke survivors and is a known risk factor of falls. Outdoor ambulation is essential for everyone, even for basic activities of daily living, but routine assessment of stroke survivors concentrates mainly on indoor ambulation and function. This study is an attempt to document gait parameters in stroke survivors and typical adults during outdoor ambulation. Method: For this prospective pilot study, 7 chronic adult stroke survivors and 7 age-matched typical adults were recruited by convenience. Measurements were taken of their ankle and subtalar joint angles during various phases of gait, using video analysing software, Kinovea 0.8.15. Results: Large differences in range of motion in the ankle and subtalar joints were noticed between stroke survivors and typical adults during ambulation on various surfaces. During ambulation on a firm surface, plantar flexion range of motion at the ankle was greater at initial contact and mid-stance, whereas on pebbled surfaces vast differences could be seen on initial contact and mid-stance.  Conclusion and Implications: Significant stance phase deviations are evident in stroke survivors during ambulation on uneven terrain. This may be a risk for falls and musculoskeletal degeneration. Although definitive conclusions cannot be drawn due to the small sample size, these findings indicate a need for considering outdoor gait evaluation in routine practice in the community. Mobility correlates highly with quality of life and meaningful strategies to adopt safe ambulation methods can be developed only with proper evaluation methods.