ORIGINAL ARTICLE Footprint peak time and functional ambulation profile reflect the potential for hemiparetic gait recovery EKATERINA B. TITIANOVA 1 , PLAMEN S. MATEEV 2 , SINIKKA H. PEURALA 3 , JUHANI SIVENIUS 3 , & INA M. TARKKA 3 1 Military Medical Academy, Sofia, Bulgaria, 2 Bulgarian Academy of Science, Sofia, Bulgaria, and 3 Brain Research and Rehabilitation Center Neuron, Kuopio, Finland (Received 29 April 2004; accepted 23 August 2004) Abstract Objective: Gait disturbances were monitored in patients with chronic stroke with a walkway built with pressure sensors in order to assess whether detailed gait and footprint information could provide verification for the potential for gait recovery. Methods: Gait variables (footprint peak times, temporal and spatial parameters and Functional Ambulation Profile, FAP, scores), were first recorded in 25 patients with chronic stroke at their preferred speed and 10 healthy volunteers walking from very slow to very fast. Patients and controls were divided into four groups based on the velocity performance. Secondly, the effect of rehabilitation on the footprint peak times was evaluated in another group of 20 chronic stroke patients. Results and conclusions: The footprint peak time behaviour of different patients with chronic stroke reflected their hemiparetic gait pattern. The slower patients had prolonged footprint peak times on the non-affected side (NS) and shorter values on the lateral footprint on the affected side (AS). The increased gait velocity and the FAP scores decreased the footprint peak times on both sides, especially on the NS. The rehabilitation increased the gait velocity with 18.2%, decreased the duration of the mid-foot and forefoot peak times on the NS and the lateral mid-foot peak times on the AS. A detailed analysis of the individual gait performance allows more accurate assessment of the potential for gait recovery. Keywords: Cerebral infarction, cerebral haemorrhage, functional disability, GAITRite, walking, pressure sensors, rehabilitation Introduction Since the impairment of gait is responsible for a long-term disability and handicap in many patients with chronic stroke, the restoration of gait is a major goal in neurological rehabilitation. Most of the recovery of walking occurs within the first 3–6 months [1] and may continue over a period of years in some individuals [2]. Still, problems of mobility often remain in those patients in whom a partial recovery is observed [3]. The variations of chronic gait abnormalities, secondary to supraspinal brain lesion, appeared to be more quantitative rather than qualitative in nature [4]. The temporal gait variables change in a stereotyped manner, regardless of the degree of functional disability, the type or the side of stroke. A typical asymmetrical pattern of hemiparetic ambulation, including bilateral abnormalities in motor perform- ance and disturbed muscle co-ordination during walking, has been described in patients with chronic stroke [5–8]. The walking velocity affect the spatial and temporal variables of gait in both healthy subjects and patients, suggesting that the gait deficit could be classified on the basis of walking speed [9]. Regarding the early prognosis of motor recovery, among other factors the initial grade of paresis (measured on hospital admission) implies the worst prognosis for subsequent motor recovery [10]. Relatively few data exist concerning the association of functional outcome and the degree of gait recovery in the chronic stage of stroke. Thus, before selecting the rehabilitation strategy and starting the therapy, a comprehensive assessment is needed to evaluate Correspondence: Ina M. Tarkka, PhD, Director of Research, Brain Research and Rehabilitation Center Neuron, Kortejoki, FIN–71130 Kuopio, Finland. E-mail: ina.tarkka@neuron.fi ISSN 0269–9052 print/ISSN 1362–301X online # 2005 Taylor & Francis Group Ltd DOI: 10.1080/02699050400013634 Brain Injury, August 2005; 19(8): 623–631