Background
Methods
Participants
Instrumentation
Procedure
Data analysis
Results
Participants
Healthy subjects | Individuals with stroke | |||||||
---|---|---|---|---|---|---|---|---|
Women | Men | Women | Men | Berg Balance Scale | Dynamic gait index | 1-min walking test | 10-m walking test | |
10–19 | 23 | 24 | 2 | 3 | 53.25 (4.19) | 23.60 (0.89) | 82.20 (12.97) | 7.06 (0.64) |
20–29 | 26 | 37 | 4 | 2 | 53.17 (4.67) | 21.33 (5.13) | 64.00 (38.29) | 8.48 (3.70) |
30–39 | 22 | 33 | 5 | 6 | 54.88 (1.36) | 22.40 (2.88) | 70.90 (16.44) | 8.61 (1.34) |
40–49 | 29 | 14 | 6 | 10 | 51.00 (5.42) | 20.81 (3.82) | 65.88 (24.44) | 10.55 (6.45) |
50–59 | 26 | 18 | 6 | 18 | 50.61 (7.21) | 20.87 (4.24) | 58.61 (16.51) | 11.43 (4.73) |
60–69 | 28 | 19 | 2 | 11 | 48.38 (9.45) | 18.38 (7.94) | 50.31 (23.84) | 18.41 (19.99) |
≥ 70 | 32 | 24 | 2 | 5 | 43.57 (9.50) | 17.00 (5.35) | 42.86 (12.05) | 12.87 (4.48) |
Total | 186 | 169 | 27 | 55 | 50.44 (7.29) | 20.51 (5.02) | 60.75 (22.69) | 11.79 (9.56) |
Performance comparison
Age decade | |||||||
---|---|---|---|---|---|---|---|
10–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | ≥70 | |
Speed (m/s) | 1.16 (0.15) | 1.18 (0.15) | 1.16* (0.12) | 1.19** (0.15) | 1.16** (0.19) | 1.06** (0.17) | 0.94** (0.19) |
Stride length (m) | 1.23** (0.11) | 1.32 (0.11) | 1.29** (0.10) | 1.27** (0.14) | 1.25** (0.14) | 1.19** (0.16) | 1.05** (0.16) |
Stride time (s) | 1.08** (0.09) | 1.13 (0.10) | 1.12 (0.10) | 1.08** (0.09) | 1.09** (0.12) | 1.13** (0.10) | 1.19 (0.12) |
Step length (m) | 0.63* (0.05) | 0.67 (0.06) | 0.65** (0.05) | 0.64** (0.07) | 0.62** (0.07) | 0.60** (0.08) | 0.52** (0.08) |
Step time (s) | 0.54** (0.05) | 0.56 (0.05) | 0.56 (0.05) | 0.54** (0.05) | 0.55** (0.06) | 0.56** (0.05) | 0.59 (0.07) |
Step width (m) | 0.11** (0.03) | 0.12 (0.03) | 0.12** (0.03) | 0.11** (0.02) | 0.12** (0.03) | 0.10** (0.03) | 0.13** (0.04) |
Cadence (step/min) | 111.87**(9.27) | 107.43 (9.60) | 107.87 (10.25) | 112.37** (9.36) | 111.15** (12.03) | 107.56** (9.10) | 102.04 (9.99) |
Step asymmetry (m) | 0.05** (0.08) | 0.06 (0.13) | 0.04* (0.02) | 0.05* (0.03) | 0.06* (0.13) | 0.12 (0.26) | 0.07 (0.08) |
Swing time (s) | 0.40 (0.05) | 0.43 (0.14) | 0.43* (0.15) | 0.41 (0.12) | 0.41 (0.14) | 0.42 (0.12) | 0.42** (0.07) |
Double support time (s) | 0.28 (0.07) | 0.29 (0.08) | 0.29* (0.07) | 0.29** (0.09) | 0.31** (0.10) | 0.37 (0.19) | 0.42 (0.19) |
Trunk obliquity (°) | 4.35 (1.36) | 5.05 (1.66) | 4.69* (1.18) | 4.29 (1.25) | 5.17 (2.82) | 4.87** (1.52) | 4.76** (1.31) |
Trunk tilt (°) | 6.29 (1.68) | 6.26 (0.95) | 6.35* (1.64) | 5.90** (1.02) | 5.28** (1.02) | 5.47** (1.26) | 5.55** (1.43) |
Trunk rotation (°) | 14.17** (3.95) | 15.61 (3.95) | 16.12* (3.65) | 17.08* (3.82) | 17.34 (3.11) | 17.80 (5.25) | 14.87** (3.89) |
Pelvic obliquity (°) | 8.35 (2.14) | 6.46 (1.98) | 7.63 (2.55) | 7.49 (3.11) | 7.72 (2.12) | 7.41 (1.64) | 8.22 (1.80) |
Pelvic tilt (°) | 17.34 (3.85) | 13.68 (3.85) | 16.08 (5.38) | 16.75 (8.25) | 17.08 (5.59) | 19.13 (5.64) | 19.67 (5.46) |
Pelvic rotation (°) | 11.12 (4.06) | 10.16* (3.74) | 11.04 (3.62) | 13.08 (2.90) | 10.15* (2.27) | 11.72 (3.29) | 11.03* (3.09) |
Hip abduction-adduction (°) | 10.19 (2.51) | 10.09 (1.98) | 9.39** (2.10) | 11.26 (3.19) | 11.95 (3.47) | 11.56 (1.69) | 12.58 (3.70) |
Hip flexion-extension (°) | 57.36 (6.33) | 53.82 (6.06) | 52.70 (5.76) | 56.58 (4.76) | 56.72* (5.72) | 55.94* (7.71) | 48.42 (8.65) |
Hip height variation (cm) | 0.06 (0.01) | 0.07** (0.01) | 0.07 (0.01) | 0.06 (0.01) | 0.06 (0.01) | 0.06 (0.01) | 0.05 (0.01) |
Knee valgus-varus alignment (°) | 18.42 (3.73) | 19.52 (4.56) | 17.65 (5.51) | 19.17 (5.44) | 21.68 (4.46) | 21.61 (4.42) | 22.81 (7.42) |
Knee flexion-extension (°) | 52.45 (4.19) | 50.66 (7.66) | 50.33** (4.85) | 50.53 (5.58) | 47.97 (5.80) | 47.75 (5.27) | 46.38 (6.24) |
Knee height variation (cm) | 0.16 (0.13) | 0.10 (0.02) | 0.10 (0.04) | 0.10 (0.07) | 0.09 (0.05) | 0.08 (0.04) | 0.11 (0.09) |
Ankle height variation (cm) | 0.17 (0.04) | 0.20** (0.03) | 0.20 (0.09) | 0.21 (0.06) | 0.17 (0.02) | 0.17 (0.02) | 0.17 (0.05) |
Age decade | |||||||
---|---|---|---|---|---|---|---|
10–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | ≥70 | |
Speed (m/s) | 1.13 (0.22) | 1.18 (0.34) | 1.03* (0.26) | 0.90** (0.31) | 0.81** (0.28) | 0.75** (0.37) | 0.67** (0.14) |
Stride length (m) | 1.40** (0.11) | 1.30 (0.26) | 1.16** (0.20) | 1.07** (0.25) | 1.00** (0.28) | 0.92** (0.37) | 0.82** (0.18) |
Stride time (s) | 1.31** (0.34) | 1.15 (0.19) | 1.17 (0.19) | 1.26** (0.28) | 1.31** (0.27) | 1.35** (0.30) | 1.22 (0.11) |
Step length (m) | 0.68* (0.08) | 0.64 (0.10) | 0.58** (0.10) | 0.55** (0.12) | 0.49** (0.14) | 0.46** (0.19) | 0.41** (0.08) |
Step time (s) | 0.64** (0.18) | 0.58 (0.11) | 0.59 (0.10) | 0.63** (0.14) | 0.65** (0.12) | 0.68** (0.15) | 0.61 (0.06) |
Step width (m) | 0.15** (0.05) | 0.13 (0.03) | 0.17** (0.06) | 0.18** (0.05) | 0.21** (0.07) | 0.18** (0.05) | 0.17** (0.06) |
Cadence (step/min) | 97.66** (15.79) | 107.41 (15.90) | 105.02 (15.07) | 99.22** (20.24) | 94.34** (14.48) | 92.23** (17.62) | 98.96 (9.79) |
Step asymmetry (m) | 0.28** (0.24) | 0.04 (0.04) | 0.05* (0.04) | 0.08* (0.08) | 0.07* (0.05) | 0.06 (0.05) | 0.10 (0.05) |
Swing time (s) | 0.33 (0.13) | 0.47 (0.09) | 0.38* (0.08) | 0.41 (0.07) | 0.36 (0.11) | 0.41 (0.06) | 0.33** (0.13) |
Double support time (s) | 0.32 (0.07) | 0.26 (0.19) | 0.37* (0.20) | 0.46** (0.21) | 0.47** (0.17) | 0.46 (0.23) | 0.45 (0.15) |
Trunk obliquity (°) | 5.85 (2.47) | 4.97 (1.74) | 6.19* (2.51) | 6.44 (3.72) | 6.97 (3.64) | 8.27** (3.61) | 7.58** (2.54) |
Trunk tilt (°) | 8.04 (1.70) | 7.95* (1.99) | 8.32* (2.72) | 9.15** (3.10) | 7.96** (2.92) | 9.99** (5.47) | 9.49** (3.79) |
Trunk rotation (°) | 21.7** (4.45) | 16.82 (4.29) | 22.42* (9.23) | 21.93* (6.95) | 22.24 (8.81) | 17.06 (5.56) | 20.25 (3.04) |
Pelvic obliquity (°) | 9.27 (1.64) | 6.88 (2.60) | 9.55 (3.07) | 9.52 (2.85) | 9.16 (2.17) | 7.85 (1.64) | 9.22 (4.05) |
Pelvic tilt (°) | 19.86 (4.53) | 13.84 (5.51) | 23.29* (9.87) | 20.74 (7.74) | 23.74 (9.77) | 20.20 (8.68) | 21.56 (8.67) |
Pelvic rotation (°) | 15.45 (4.75) | 15.20* (7.09) | 14.68 (6.33) | 16.01 (5.94) | 15.66* (7.06) | 12.12 (5.45) | 13.63* (1.81) |
Hip abduction-adduction (°) | 11.74 (3.22) | 10.58 (2.59) | 13.33** (2.45) | 13.00 (3.52) | 12.05 (2.09) | 12.02 (2.89) | 14.20 (2.06) |
Hip flexion-extension (°) | 59.49 (9.03) | 56.49 (6.80) | 55.22 (7.82) | 52.84 (7.22) | 49.28* (9.49) | 49.52* (8.18) | 45.30 (9.86) |
Hip height variation (cm) | 0.20 (0.24) | 0.37** (0.32) | 0.07 (0.02) | 0.18 (0.34) | 0.06 (0.02) | 0.07 (0.06) | 0.05 (0.01) |
Knee valgus-varus alignment (°) | 22.17 (11.84) | 19.41 (5.98) | 21.79 (7.10) | 19.36 (6.11) | 18.61 (4.40) | 19.95 (6.01) | 22.97 (4.97) |
Knee flexion-extension (°) | 49.37 (7.36) | 45.03 (16.58) | 43.74** (8.14) | 50.06 (12.75) | 44.89 (8.83) | 39.60 (15.53) | 41.40 (8.89) |
Knee height variation (cm) | 0.19 (0.16) | 0.09 (0.03) | 0.15 (0.16) | 0.10 (0.03) | 0.13 (0.12) | 0.18 (0.24) | 0.12 (0.05) |
Ankle height variation (cm) | 0.23 (0.11) | 0.33** (0.13) | 0.19 (0.05) | 0.23 (0.13) | 0.17 (0.05) | 0.17 (0.07) | 0.14 (0.05) |
Concurrent validity
Dynamic gait index | 1-min walking test | 10-m walking test | |
---|---|---|---|
Speed (m/s) | r = 0.793** | r = 0.754** | r = −0.675** |
Stride length (m) | r = 0.822** | r = 0.684** | r = −0.726** |
Stride time (s) | r = − 0.645** | r = − 0.608** | r = 0.596** |
Step length (m) | r = 0.806** | r = 0.707** | r = − 0.721** |
Step time (s) | r = −0.658** | r = − 0.622** | r = 0.602** |
Step width (m) | r = −0.400** | r = −0.342** | r = 0.332** |
Cadence (step/min) | r = 0.614** | r = 0.654** | r = −0.557** |
Step asymmetry (m) | r = −0.092 | r = −0.028 | r = 0.053 |
Swing time (s) | r = 0.376** | r = 0.274* | r = −0.475** |
Double support time (s) | r = −0.554** | r = −0.551** | r = 0.505** |
Trunk obliquity (°) | r = −0.539** | r = −0.520** | r = 0.571** |
Trunk tilt (°) | r = −0.599** | r = −0.427** | r = 0.688** |
Trunk rotation (°) | r = 0.136 | r = −0.088 | r = 0.014 |
Pelvic obliquity (°) | r = −0.180 | r = −0.147 | r = 0.073 |
Pelvic tilt (°) | r = −0.344** | r = −0.297* | r = 0.317** |
Pelvic rotation (°) | r = −0.056 | r = 0.021 | r = 0.049 |
Hip abduction-adduction (°) | r = −0.342** | r = −0.184 | r = 0.281* |
Hip flexion-extension (°) | r = 0.436** | r = 0.437** | r = −0.241* |
Hip height variation (cm) | r = 0.191 | r = 0.368** | r = −0.173 |
Knee valgus-varus alignment (°) | r = 0.034 | r = 0.080 | r = −0.037 |
Knee flexion-extension (°) | r = 0.255* | r = 0.135 | r = −0.296** |
Knee height variation (cm) | r = 0.013 | r = −0.036 | r = −0.126 |
Ankle height variation (cm) | r = 0.436** | r = 0.536** | r = −0.342** |
Inter and intra-rater reliability, standard error of measurement, and minimal detectable change
Inter-rater reliability | Intra-rater reliability | Standard error of measurement | Minimal detectable change | |
---|---|---|---|---|
Speed (m/s) | r = 0.970** | r = 0.970** | 0.04 | 0.12 (12.4%) |
Stride length (m) | r = 0.975** | r = 0.982** | 0.03 | 0.09 (8.1%) |
Stride time (s) | r = 0.948** | r = 0.958** | 0.03 | 0.10 (8.1%) |
Step length (m) | r = 0.977** | r = 0.970** | 0.02 | 0.06 (10.6%) |
Step time (s) | r = 0.947** | r = 0.960** | 0.02 | 0.05 (7.8%) |
Step width (m) | r = 0.943** | r = 0.894** | 0.01 | 0.03 (23.9%) |
Cadence (step/min) | r = 0.939** | r = 0.951** | 3.17 | 8.79 (8.6%) |
Step asymmetry (m) | r = 0.636* | r = 0.767** | 0.03 | 0.09 (103.4%) |
Swing time (s) | r = 0.834** | r = 0.802** | 0.04 | 0.11 (33.0%) |
Double support time (s) | r = 0.904** | r = 0.814** | 0.08 | 0.22 (50.7%) |
Trunk obliquity (°) | r = 0.846** | r = 0.805** | 1.01 | 2.80 (35.7%) |
Trunk tilt (°) | r = 0.905** | r = 0.886** | 0.77 | 2.15 (25.1%) |
Trunk rotation (°) | r = 0.913** | r = 0.885** | 2.62 | 7.25 (28.1%) |
Pelvic obliquity (°) | r = 0.821** | r = 0.924** | 2.10 | 5.81 (54.1%) |
Pelvic tilt (°) | r = 0.877** | r = 0.965** | 6.07 | 16.82 (78.4%) |
Pelvic rotation (°) | r = 0.968** | r = 0.942** | 2.42 | 6.70 (35.8%) |
Hip abduction-adduction (°) | r = 0.787** | r = 0.838** | 2.05 | 5.69 (42.0%) |
Hip flexion-extension (°) | r = 0.889** | r = 0.862** | 3.26 | 9.04 (16.5%) |
Hip height variation (cm) | r = 0.746** | r = 0.856** | 0.01 | 0.04 (56.9%) |
Knee valgus-varus alignment (°) | r = 0.881** | r = 0.915** | 2.48 | 6.90 (32.5%) |
Knee flexion-extension (°) | r = 0.893** | r = 0.938** | 2.59 | 7.17 (15.0%) |
Knee height variation (cm) | r = 0.829** | r = 0.711** | 0.08 | 0.22 (110.7%) |
Ankle height variation (cm) | r = 0.922** | r = 0.859** | 0.02 | 0.05 (29.8%) |
Ability to discriminate between fallers and non-fallers
Higher fall risk | Lower fall risk | Statistical significance | ROC | |
---|---|---|---|---|
Speed (m/s) | 0.55 (0.32) | 1.00 (0.23) | p = 0.000 | 0.866 |
Stride length (m) | 0.76 (0.37) | 1.14 (0.20) | p = 0.000 | 0.826 |
Stride time (s) | 1.52 (0.32) | 1.17 (0.15) | p = 0.000 | 0.857 |
Step length (m) | 0.38 (0.18) | 0.57 (0.10) | p = 0.000 | 0.833 |
Step time (s) | 0.75 (0.15) | 0.58 (0.07) | p = 0.000 | 0.846 |
Step width (m) | 0.21 (0.07) | 0.17 (0.05) | p = 0.015 | 0.668 |
Cadence (step/min) | 81.88 (15.71) | 103.92 (12.51) | p = 0.000 | 0.858 |
Step asymmetry (m) | 0.09 (0.05) | 0.07 (0.10) | p = 0.401 | 0.685 |
Swing time (s) | 0.31 (0.14) | 0.40 (0.08) | p = 0.003 | 0.715 |
Double support time (s) | 0.56 (0.18) | 0.37 (0.17) | p = 0.000 | 0.797 |
Trunk obliquity (°) | 9.54 (4.72) | 5.90 (2.14) | p = 0.000 | 0.759 |
Trunk tilt (°) | 11.53 (5.02) | 7.75 (2.14) | p = 0.000 | 0.762 |
Trunk rotation (°) | 22.50 (7.89) | 20.09 (7.13) | p = 0.228 | 0.612 |
Pelvic obliquity (°) | 9.83 (3.40) | 8.50 (2.15) | p = 0.052 | 0.590 |
Pelvic tilt (°) | 25.24 (12.35) | 20.03 (7.15) | p = 0.029 | 0.606 |
Pelvic rotation (°) | 15.67 (6.81) | 14.67 (5.95) | p = 0.552 | 0.541 |
Hip abduction-adduction (°) | 13.43 (3.43) | 11.95 (2.31) | p = 0.039 | 0.612 |
Hip flexion-extension (°) | 45.97 (10.91) | 53.54 (7.79) | p = 0.002 | 0.725 |
Hip height variation (cm) | 0.06 (0.03) | 0.13 (0.22) | p = 0.189 | 0.651 |
Knee valgus-varus alignment (°) | 18.75 (6.69) | 20.05 (5.13) | p = 0.390 | 0.577 |
Knee flexion-extension (°) | 44.35 (8.07) | 46.12 (11.36) | p = 0.552 | 0.549 |
Knee height variation (cm) | 0.13 (0.10) | 0.13 (0.14) | p = 0.972 | 0.575 |
Ankle height variation (cm) | 0.14 (0.04) | 0.21 (0.10) | p = 0.004 | 0.760 |