Effects of repeated treadmill testing and electrical stimulation on post-stroke gait kinematics

Improvements in task performance due to repeated testing have previously been documented in healthy and patient populations. The existence of a similar change in performance due to repeated testing has not been previously investigated at the level of gait kinematics in the post-stroke population. The presence of such changes may define the number of testing sessions necessary for measuring a stable baseline of pre-training gait performance, which is a necessary prerequisite for determining the effectiveness of gait interventions. Considering the emergence of treadmills as a popular tool for gait evaluation and retraining and the common addition of functional electrical stimulation (FES) to gait retraining protocols, the stability of gait kinematics during the repeated testing of post-stroke individuals on a treadmill, either with or without FES, needs to be determined. Nine individuals (age: 58.1 ± 7.3 years), with hemi-paresis secondary to a stroke (onset: 7.3 ± 6.0 years) participated in this study. An 8-camera motion analysis system was used to measure sagittal plane knee and ankle joint kinematics. Gait kinematics were compared across two (N = 9) and five (N = 5) testing sessions. No consistent changes in knee or ankle kinematics were observed during repeated testing. These findings indicate that clinicians and researchers may not need to spend valuable time and resources performing multiple testing and acclimatization sessions when assessing baseline gait kinematics in the post-stroke population for use in determining the effectiveness of gait interventions.

► Post-stroke kinematics show no consistent change during repeated treadmill testing. ► This finding persists even with the addition of functional electrical stimulation. ► Only one testing session may be necessary to assess post-stroke gait kinematics.