Comparison of three kinematic gait event detection methods during overground and treadmill walking for individuals post stroke.

Detecting gait events using ground reaction forces (i.e. kinetic detection) is the gold standard, but it is not always possible. Kinematic methods exist; however, accuracy of these methods in stroke survivors during treadmill and overground walking is unknown. Thus, this study compared the accuracy of three kinematic methods during overground and treadmill walking in stroke survivors. Heel strike and toe off were calculated bilaterally using three kinematic methods (horizontal sacral-heel distance, horizontal ankle-heel distance, and horizontal velocity) and a kinetic method for ten stroke survivors. We calculated true and absolute error for each kinematic method relative to the kinetic method to evaluate accuracy. Repeated-measures ANOVAs compared the absolute error between the different methods for each condition. There was a significant effect of method for all conditions except heel strike during treadmill walking. Post hoc tests showed ankle-heel distance detected heel strike with significantly less error than the other methods during overground walking (p < 0.05). Ankle-heel distance identified 93.0% and 77.8% of gait events within 50 ms of the kinetic event for overground and treadmill walking, respectively. Sacral-heel distance detected toe-off with significantly less error than the other methods during overground and treadmill walking (p < 0.05) and identified 87.2% and 90.3% of gait events within 50 ms of the kinetic event for overground and treadmill walking, respectively. Results suggest that ankle-heel distance and sacral-heel distance accurately detect heel strike and toe-off, respectively, in stroke survivors.