Effects of hip abduction and adduction accuracy on post‐stroke gait

Background Gait instability often limits post‐stroke function, although the mechanisms underlying this instability are not entirely clear. Our recent work has suggested that one possible factor contributing to post‐stroke gait instability is a reduced ability to accurately control foot placement. The purpose of the present experiments was to investigate whether post‐stroke gait function is related to the ability to accurately abduct and adduct the hip, as required for accurate foot placement. Methods 35 chronic stroke survivors and 12 age‐matched controls participated in this experiment. Participants performed hip oscillation trials designed to quantify hip abduction/adduction accuracy, in which they lay supine and moved their leg through a prescribed range of motion in time with a metronome. Stroke survivors also performed overground walking trials at their self‐selected speed. Findings 28 of the 35 stroke survivors had sufficient active range of motion to perform the prescribed hip oscillation task. In comparison to controls, these 28 stroke survivors were significantly less accurate at matching the abduction target, matching the adduction target, and moving in time with the metronome. Across these stroke survivors, a multiple regression revealed that only paretic hip abduction accuracy made a unique contribution to predicting paretic step width and paretic step period, metrics of gait performance. Interpretation The present results demonstrate that the ability to accurately abduct the hip is related to post‐stroke gait performance, as predicted from a model‐based gait stabilization strategy. Therefore, interventions designed to improve lower limb movement accuracy may hold promise for restoring post‐stroke gait stability. HighlightsFunctional mobility of individuals with stroke is often limited by gait instability.Accurate mediolateral foot placement typically helps stabilize gait.Individuals with stroke were less accurate at abducting and adducting their paretic hip.Hip abduction accuracy was predictive of post‐stroke gait performance.