Relationship between lower limb coordination and walking speed after stroke: an observational study

Although lower limb muscle strength is associated with walking performance in people after stroke, even when there is good strength, walking speed may remain slower than normal, perhaps due to incoordination. The aim of this study was to examine the relationship between walking speed and lower limb coordination in people with good strength after stroke. An observational study was conducted with 30 people with stroke and 30 age-matched controls. Inclusion criteria for stroke were good lower limb strength (i.e., ≥Grade 4) and walking speed at >0.6m/s without aids in bare feet (with recruitment stratified so that walking speed was evenly represented across the range). Walking performance was measured as speed during the 10-m Walk Test and distance during the 6-min Walk Test. Coordination was measured using the Lower Extremity Motor Coordination Test and reported in taps/s. Stroke survivors walked at 1.00 (SD 0.26) m/s during the10-m Walk Test (64% of normal), walked 349 (SD 94) m during the 6-min Walk Test (68% of normal), and performed the Lower Extremity Motor Coordination Test at 1.20 (SD 0.34) taps/s with the affected side (64% of normal). Lower Extremity Motor Coordination Test scores for the affected side were statistically significantly correlated with walking performance in the 10-m Walk Test (r=0.42, p=0.02) and the 6-min Walk Test (r=0.50, p=0.01). Coordination was related to walking performance, suggesting that loss of coordination may contribute to slow walking in this group of stroke survivors with good strength. Trial registration: ANZCTR12614000856617 (www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366827).