The purpose of this study was to determine whether gait variability indices can accurately discriminate independent walking in post-stroke patients and to determine the cut-off values required for independent walking.
The subjects were post-stroke patients admitted to a rehabilitation ward. All measurements were taken before one week of discharge. Walking independence was measured using the Functional Ambulation Categories (FAC). Gait variability was measured using the WalkWay MW-1000 (length 2.4 m, ANIMA, Co., Ltd., Tokyo, Japan). Participants walked on the walkway 4 to 12 times at a comfortable speed. Spatiotemporal parameter data were collected for at least 20 steps. These parameters included stride time, step time, single support time, and step length, all extracted from the paretic side. Gait variability was assessed using the coefficient of variation. Participants were classified into two groups based on FAC: the independent walking group (FAC ≥ 4) and the non-independent walking group (FAC ≤ 3). A Mann-Whitney U test was used to analyze differences in gait variability indices between the groups. Receiver operating characteristic (ROC) curve analysis was performed to assess the accuracy of gait variability indices in discriminating independent walking. Sensitivity, specificity, and AUC were calculated for each gait variability index, and cut-off values were determined using the Youden index.
Ninety-four participants were included, with 52% in the independent walking group and 48% in the non-independent walking group. The independent walking group had significantly lower gait variability indices compared to the non-independent walking group. The cut-off values and discriminative accuracy of gait variability indices for walking independence were as follows: stride time, cut-off value 4.32 (sensitivity 0.735, specificity 0.867, AUC 0.844); step time, cut-off value 6.08 (sensitivity 0.796, specificity 0.800, AUC 0.852); single support time, cut-off value 7.82 (sensitivity 0.816, specificity 0.822, AUC 0.887); step length, cut-off value 9.97 (sensitivity 0.878, specificity 0.667, AUC 0.812).
Gait variability indices in post-stroke patients were able to discriminate independent walking with moderate accuracy. The cut-off values for each gait variability indices were 4.32 for stride time, 6.08 for step time, 7.82 for single support time, and 9.97 for step length.
Gait variability indices may be useful as indicators of independent walking in post-stroke patients. These results suggest the importance of including gait stability in the assessment of independent walking.
Gait variability
Independent walking
