Distance-related changes in gait parameters during uneven-surface walking in people with stroke versus healthy controls: A cross-sectional analysis

IF 1.8 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-09 DOI:10.1016/j.clinbiomech.2026.106747

Yasuhiro Inui , Naomichi Mizuta , Yuta Terasawa , Tomoya Tanaka , Naruhito Hasui , Kazuki Hayashida , Yuki Nishi , Shu Morioka

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引用次数: 0

Abstract

Background

People with Stroke (PwS) struggle with walking outdoors, especially on uneven surfaces, which limits their social participation. Distance-related changes on uneven surfaces remain unclear. We compared these changes between PwS and healthy controls (HC).

Methods

Nineteen PwS and 19 HC walked four laps on a 10-m uneven surface. Gait speed, root mean square of trunk acceleration (stability), maximum joint angles, electromyography (EMG) amplitude, and instantaneous mean frequency (IMNF) were measured. Linear mixed models were used to compare gait-parameter changes across laps.

Findings

No group × lap interaction was detected for gait speed, stability, stance-phase hip extension, or swing-phase knee flexion. An interaction was observed for ankle dorsiflexion during initial contact (p = 0.036; decreased across laps in PwS). For EMG amplitude, tibialis anterior during initial contact showed an interaction (p = 0.036; increased only in HC). Regarding IMNF, gluteus medius showed a group main effect during mid-stance (p < 0.001; higher in PwS) and an interaction during terminal stance (p = 0.036; decreased only in PwS); during mid-swing, group main effects were observed for rectus femoris (p = 0.044), biceps femoris (p = 0.011), and gluteus medius (p = 0.023), with higher IMNF in PwS.

Interpretation

PwS maintained gait speed and stability, increasing distances on uneven surfaces, showing adaptations comparable to HC. PwS did not sufficiently augment tibialis anterior amplitude, accompanied by reduced ankle dorsiflexion and limited shock absorption. Elevated IMNF indicates greater motor-unit recruitment contributing to the maintenance of joint angles, whereas gluteus medius IMNF declined during terminal stance, suggesting fatigue. Overall, adaptation was present but limited, with a risk of fatigue.

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中风患者与健康对照者在不平整路面行走时步态参数的距离相关变化：一项横断面分析

背景：中风患者（PwS）在户外行走困难，特别是在不平坦的地面上行走，这限制了他们的社会参与。不平坦表面上与距离相关的变化尚不清楚。我们比较了PwS和健康对照（HC）之间的这些变化。方法：19名PwS和19名HC在10米不平路面上行走4圈。测量步态速度、躯干加速度（稳定性）均方根、最大关节角、肌电图（EMG）振幅和瞬时平均频率（IMNF）。采用线性混合模型比较跨圈的步态参数变化。研究结果：没有发现x组膝盖的相互作用对步态速度、稳定性、站立阶段髋关节伸展或摆动阶段膝关节屈曲的影响。在初次接触时观察到踝关节背屈的相互作用（p = 0.036；在PwS中跨圈减少）。对于肌电图振幅，胫骨前肌在初次接触时表现出相互作用（p = 0.036；仅在HC时增加）。关于IMNF，臀中肌在中位站立时表现出群体主要作用(p)解释：PwS保持步态速度和稳定性，在不平整的表面上增加距离，表现出与HC相当的适应性。PwS不能充分增强胫骨前肌振幅，同时伴有踝关节背屈减少和减震。IMNF升高表明运动单元的增加有助于关节角度的维持，而臀中肌IMNF在终末站立时下降，表明疲劳。总的来说，适应是存在的，但有限，有疲劳的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.