Abstract
Introduction Stroke survivors often fall during walking. To reduce fall risk, gait testing and training with avoidance of virtual obstacles is gaining popularity. However, it is unknown whether and how virtual obstacle crossing is associated with fall risk. Aim The present study assessed whether obstacle crossing characteristics are reliable and assessed differences in stroke survivors who prospectively experienced falls or no falls. Method We recruited twenty-nine community dwelling chronic stroke survivors. Participants crossed five virtual obstacles with increasing lengths. After a break, the test was repeated to assess test-retest reliability. For each obstacle length and trial, we determined; success rate, leading limb preference, pre and post obstacle distance, margins of stability, toe clearance, and crossing step length and speed. Subsequently, fall incidence was monitored using a fall calendar and monthly phone calls over a six-month period. Results Test-retest reliability was poor, but improved with increasing obstacle-length. Twelve participants reported at least one fall. No association of fall incidence with any of the obstacle crossing characteristics was found. Discussion Given the absence of height of the virtual obstacles, obstacle avoidance may have been relatively easy, allowing participants to cross obstacles in multiple ways, increasing variability of crossing characteristics and reducing the association with fall risk. Conclusion These finding cast some doubt on current protocols for testing and training of obstacle avoidance in stroke rehabilitation.
| Original language | English |
|---|---|
| Pages (from-to) | 533-538 |
| Number of pages | 6 |
| Journal | Gait and Posture |
| Volume | 58 |
| DOIs | |
| Publication status | Published - 1 Oct 2017 |
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Keywords
- Gait
- Obstacle crossing
- Prospective falls
- Stroke
- Virtual environment
Cite this
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Virtual obstacle crossing : Reliability and differences in stroke survivors who prospectively experienced falls or no falls. / Punt, Michiel; Bruijn, Sjoerd M.; Wittink, Harriet; van de Port, Ingrid G.; Wubbels, Gijs; van Dieën, Jaap H.
In: Gait and Posture, Vol. 58, 01.10.2017, p. 533-538.Research output: Contribution to Journal › Article › Academic › peer-review
TY - JOUR
T1 - Virtual obstacle crossing
T2 - Reliability and differences in stroke survivors who prospectively experienced falls or no falls
AU - Punt, Michiel
AU - Bruijn, Sjoerd M.
AU - Wittink, Harriet
AU - van de Port, Ingrid G.
AU - Wubbels, Gijs
AU - van Dieën, Jaap H.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Introduction Stroke survivors often fall during walking. To reduce fall risk, gait testing and training with avoidance of virtual obstacles is gaining popularity. However, it is unknown whether and how virtual obstacle crossing is associated with fall risk. Aim The present study assessed whether obstacle crossing characteristics are reliable and assessed differences in stroke survivors who prospectively experienced falls or no falls. Method We recruited twenty-nine community dwelling chronic stroke survivors. Participants crossed five virtual obstacles with increasing lengths. After a break, the test was repeated to assess test-retest reliability. For each obstacle length and trial, we determined; success rate, leading limb preference, pre and post obstacle distance, margins of stability, toe clearance, and crossing step length and speed. Subsequently, fall incidence was monitored using a fall calendar and monthly phone calls over a six-month period. Results Test-retest reliability was poor, but improved with increasing obstacle-length. Twelve participants reported at least one fall. No association of fall incidence with any of the obstacle crossing characteristics was found. Discussion Given the absence of height of the virtual obstacles, obstacle avoidance may have been relatively easy, allowing participants to cross obstacles in multiple ways, increasing variability of crossing characteristics and reducing the association with fall risk. Conclusion These finding cast some doubt on current protocols for testing and training of obstacle avoidance in stroke rehabilitation.
AB - Introduction Stroke survivors often fall during walking. To reduce fall risk, gait testing and training with avoidance of virtual obstacles is gaining popularity. However, it is unknown whether and how virtual obstacle crossing is associated with fall risk. Aim The present study assessed whether obstacle crossing characteristics are reliable and assessed differences in stroke survivors who prospectively experienced falls or no falls. Method We recruited twenty-nine community dwelling chronic stroke survivors. Participants crossed five virtual obstacles with increasing lengths. After a break, the test was repeated to assess test-retest reliability. For each obstacle length and trial, we determined; success rate, leading limb preference, pre and post obstacle distance, margins of stability, toe clearance, and crossing step length and speed. Subsequently, fall incidence was monitored using a fall calendar and monthly phone calls over a six-month period. Results Test-retest reliability was poor, but improved with increasing obstacle-length. Twelve participants reported at least one fall. No association of fall incidence with any of the obstacle crossing characteristics was found. Discussion Given the absence of height of the virtual obstacles, obstacle avoidance may have been relatively easy, allowing participants to cross obstacles in multiple ways, increasing variability of crossing characteristics and reducing the association with fall risk. Conclusion These finding cast some doubt on current protocols for testing and training of obstacle avoidance in stroke rehabilitation.
KW - Gait
KW - Obstacle crossing
KW - Prospective falls
KW - Stroke
KW - Virtual environment
UR - http://www.scopus.com/inward/record.url?scp=85029834842&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029834842&partnerID=8YFLogxK
U2 - 10.1016/j.gaitpost.2017.09.013
DO - 10.1016/j.gaitpost.2017.09.013
M3 - Article
VL - 58
SP - 533
EP - 538
JO - Gait and Posture
JF - Gait and Posture
SN - 0966-6362
ER -