Comparing stepping-in-place and gait ability in adults with and without hemiplegia

Objective: To determine and compare select temporal-distance measures of stepping-in-place with gait ability in 2 age-matched groups. Design: Repeated measures, matched research design. Setting: Gait laboratory and hospital outpatient unit. Participants: Convenience sample recruited from within the community and the outpatient unit of a local rehabilitation hospital included 30 healthy adults (age range, 58.1 +/- 10.8 yr) and 30 age-matched adults with hemiplegia (age range, 58.6 +/- 10.3 yr), secondary to a cerebrovascular accident. Interventions: Subjects were videotaped in the sagittal plane performing stepping-in-place and while walking. Select temporal-distance measures obtained by manual calculations from the video recordings were determined for 3 20-second trials of each activity. Main Outcome Measures: Single limb support duration (SLSD) of the lower extremities (LEs and step frequency during stepping-in-place and during gait. Results: A significant difference was found between the step frequency of each activity for the adults with hemiplegia (p <.05, but not for the healthy adults. A significant difference was also found between SLSD of the same LE across activities for each group (p <.05). SLSD of each LE during each individual activity, stepping-in-place, or gait, was not significantly different for the healthy adults, indicating LE symmetry; but it was significantly different for the adults with hemiplegia(p <.05), indicating LE asymmetry. Conclusions: Stepping-in-place incorporates reciprocal, rhythmic LE movement patterns similar to gait. And, although SLSD of the LEs was different between the activities in both groups, each group showed similar LE movement patterns during each individual activity. In addition, step frequency was consistent between the activities for the healthy adults. These results seem to indicate that the reciprocal, rhythmic LE movement patterns, which are invoked during gait, may also be invoked during stepping-in-place, However, further research is needed to enhance the data related to stepping-in-place and gait ability in clinical populations.