Analysis Acceleration/Deceleration Distance Gait Speed Tests in Stroke Survivors (Walk-test)

Analysis of Optimal Acceleration/Deceleration Distance in Gait Speed Tests With Motion Capture System in Chronic Post-stroke. Cross-sectional Study

Introduction: Gait speed is currently used to predict the future functional status of the patient or to evaluate the improvements produced by different neurorehabilitation treatments. There is no common agreement among researchers and clinicians as to the optimal distance required to accelerate and decelerate in walking tests (4-meter and 6-meter timed) in people in the chronic phase of stroke.

Objectives: The main objective is to analyze what is the optimal distance to accelerate and decelerate in the 4-meter walk test (4mWT) and 6-meter walk test (6mWT) at comfortable and fast speed with optical motion capture for chronic stroke survivors (> 6 months).

The secondary objective is to evaluate whether the mean gait speed taken by stopwatch is comparable to optical motion capture system Optitrack for the 4mWT and the 6mWT for a correct measurement of gait at comfortable and fast speed in in chronic stroke survivors.

Methods: A cross-sectional observational study is performed. The walking speed is measured using the OptiTrack optical motion capture system consisting of 8 PrimeX 13 cameras and Motive 2.0 capture and analysis software (Natural Point Inc. Corvallis OR USA).The patient ware 8 markers sensors applied to different parts of the body. The two tests are performed first at a comfortable gait and second at the fastest gait that the patient can safely perform. There were 3 repetitions for each of the tests. The individuals are randomized to start with either the 6mWT or the 4mWT test. All tests are performed on the same day.

Discussion: This study will shed light on what is the optimal distance required for acceleration and deceleration phases on the 6mWT and 4mWT walking tests at comfortable and fast speed.

Study Overview

• Status: Recruiting
• Conditions: Stroke; Chronic Stroke
• Intervention / Treatment: Other: 4 and 6 meters walking test

Detailed Description

Gait disorder is a common clinical problem after stroke and is among the prevalent physical limitations contributing to stroke-related disability that impacts performance of activities of daily(1). Gait disturbances in patients with stroke are caused by weakness (paresis or paralysis), abnormal tone in the limbs or trunk, or by disturbances in the sensory-motor system or central control mechanisms.(2) Therefore, gait recovery is a major objective in the rehabilitation program in stroke survivors.(3) Walking speed is considered to be the sixth vital sign (4). Clinical practice guidelines worldwide recommend using reliable and valid tools to assess walking in stroke rehabilitation.(5,6) The 10 meter walk test at comfortable speed is widely recommended to reflect a walking speed. (7) However, there are many different distances to accelerate and decelerate.

• Study Type: Observational
• Enrollment (Estimated): 50

Contacts and Locations

• Study Contact: Name: Carlos-Antonio Zárate-Tejero, PhD; Phone Number: +34935042000; Email: czarate@uic.es
• Study Contact Backup: Name: Victor Zárate-Lozano, MsC; Phone Number: +34935042000; Email: vzarate@uic.es

Study Locations

• Spain
  • Barcelona
    • Sant Cugat del Valles, Barcelona, Spain, 08195
      • Recruiting
      • Universitat Internacional de Catalunya
      • Contact: Carina Salgueiro, PhD; Phone Number: +34936 75 35 46; Email: carinafsalgueiro@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Stroke survivors in chronic phase > 6 months

Description

Inclusion Criteria:

• Stroke survivors in chronic phase > 6 months
• Have preserved cognitive ability: Achieve a score equal to or greater than 25 points on the Montreal Cognitive Assessment test.
• Have the ability to walk on a flat surface of at least 10 meters, with or without aid.

Exclusion Criteria:

A history of lower extremities injury or surgery

• A history of botulinum injection within 3 months
• A history of inflammatory arthritis
• A history of inflammatory myopathy or peripheral nervous disease
• A history of other neurological disease as a Parkinson, spinal cord etc.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Cross-Sectional

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceleration/deceleration distance for 6mWT at comfortable speed	Distance time that an individual needs to reach their average gait speed. Examinees are timed once the first foot passes the acceleration path; the time is stopped once the first foot enters the deceleration path.	15 minutes
Acceleration/deceleration distance for 4mWT at comfortable speed	Distance time that an individual needs to reach their average gait speed. Examinees are timed once the first foot passes the acceleration path; the time is stopped once the first foot enters the deceleration path.	15 minutes
Acceleration/deceleration distance for 6mWT at fast speed	Distance time that an individual needs to reach their average gait speed.Examinees are timed once the first foot passes the acceleration path; the time is stopped once the first foot enters the deceleration path.	15 minutes
Acceleration/deceleration distance for 4mWT at fast speed	Distance time that an individual needs to reach their average gait speed. Examinees are timed once the first foot passes the acceleration path; the time is stopped once the first foot enters the deceleration path.	15 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gait speed for 6mWT	Gait speed is the time one takes to walk a specified distance on level surfaces over a short distance.	15 minutes
Gait speed for 4mWT	Gait speed is the time one takes to walk a specified distance on level surfaces over a	15 minutes

Collaborators and Investigators

• Sponsor: Universitat Internacional de Catalunya
• Investigators: Principal Investigator: Rosa Cabanas-Valdés, PhD, Universitat Internacional de Catalunya

Publications and helpful links

General Publications

• Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31. doi: 10.1093/gerona/55.4.m221.
• Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Recovery of walking function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995 Jan;76(1):27-32. doi: 10.1016/s0003-9993(95)80038-7.
• Eng JJ, Tang PF. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Expert Rev Neurother. 2007 Oct;7(10):1417-36. doi: 10.1586/14737175.7.10.1417.
• Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, Mayorga LM. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sci. 2005 Oct;60(10):1304-9. doi: 10.1093/gerona/60.10.1304.
• Richards CL, Malouin F, Dean C. Gait in stroke: assessment and rehabilitation. Clin Geriatr Med. 1999 Nov;15(4):833-55.
• Geyh S, Cieza A, Schouten J, Dickson H, Frommelt P, Omar Z, Kostanjsek N, Ring H, Stucki G. ICF Core Sets for stroke. J Rehabil Med. 2004 Jul;(44 Suppl):135-41. doi: 10.1080/16501960410016776.
• Parker CJ, Gladman JR, Drummond AE. The role of leisure in stroke rehabilitation. Disabil Rehabil. 1997 Jan;19(1):1-5. doi: 10.3109/09638289709166438.
• Awad L, Reisman D, Binder-Macleod S. Distance-Induced Changes in Walking Speed After Stroke: Relationship to Community Walking Activity. J Neurol Phys Ther. 2019 Oct;43(4):220-223. doi: 10.1097/NPT.0000000000000293.
• Feld JA, Rabadi MH, Blau AD, Jordan BD. Berg balance scale and outcome measures in acquired brain injury. Neurorehabil Neural Repair. 2001;15(3):239-44. doi: 10.1177/154596830101500312.
• Taylor-Piliae RE, Latt LD, Hepworth JT, Coull BM. Predictors of gait velocity among community-dwelling stroke survivors. Gait Posture. 2012 Mar;35(3):395-9. doi: 10.1016/j.gaitpost.2011.10.358. Epub 2011 Nov 26.
• Cabanas-Valdes R, Garcia-Rueda L, Salgueiro C, Perez-Bellmunt A, Rodriguez-Sanz J, Lopez-de-Celis C. Assessment of the 4-meter walk test test-retest reliability and concurrent validity and its correlation with the five sit-to-stand test in chronic ambulatory stroke survivors. Gait Posture. 2023 Mar;101:8-13. doi: 10.1016/j.gaitpost.2023.01.014. Epub 2023 Jan 20.
• Ng SS, Au KK, Chan EL, Chan DO, Keung GM, Lee JK, Kwong PW, Tam EW, Fong SS. Effect of acceleration and deceleration distance on the walking speed of people with chronic stroke. J Rehabil Med. 2016 Oct 5;48(8):666-670. doi: 10.2340/16501977-2124.
• Salbach NM, MacKay-Lyons M, Howe JA, McDonald A, Solomon P, Bayley MT, McEwen S, Nelson M, Bulmer B, Lovasi GS. Assessment of Walking Speed and Distance Post-Stroke Increases After Providing a Theory-Based Toolkit. J Neurol Phys Ther. 2022 Oct 1;46(4):251-259. doi: 10.1097/NPT.0000000000000406. Epub 2022 Jun 7. Erratum In: J Neurol Phys Ther. 2023 Jan 1;47(1):63.

Study record dates

Study Major Dates

• Study Start (Actual): March 23, 2023
• Primary Completion (Estimated): September 1, 2025
• Study Completion (Estimated): December 1, 2025

Study Registration Dates

• First Submitted: December 22, 2022
• First Submitted That Met QC Criteria: January 7, 2023
• First Posted (Actual): January 10, 2023

Study Record Updates

• Last Update Posted (Actual): January 12, 2024
• Last Update Submitted That Met QC Criteria: January 9, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Keywords: walking test; gait speed; comfortable gait speed; acceleration distance; 10mWT; 6mWT; fast speed; 4 meters walk test; deceleration distance; 6 meters walk test
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: Gait speed optimal distance

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No