Inclined treadmill walking kinetics of the non-paretic leg in early post-stroke survivors: an observational case-control study.

Background: Stroke remains the primary source of prolonged disability worldwide since it often results in gait asymmetry. Research shows compensatory mechanisms in chronic stroke patients' non-paretic legs but lacks knowledge about these adaptations during the early post-stroke period when walking on inclines which mimic real-world mobility challenges. Objective: This study sought to clarify the compensatory strategies in the non-paretic leg of early post-stroke survivors by analyzing the changes in vertical ground reaction force (GRF) profiles and respective variabilities during level (0%) and inclined (6%) treadmill walking, relative to healthy, matched controls. Methods: The study included fourteen early post-stroke survivors who were three months post-event or less along with fourteen matched controls. Participants walked at their preferred speeds on treadmill at 0% and 6% grade incline settings. Researchers determined key vertical GRF profiles, including peak amplitudes (F1, F2, F3), impulses (J1-J4), timing to each peak, loading/unloading rates, and their respectively variabilities. Mixed two-way repeated measures Analysis of covariance (ANCOVA) were used and preferred walking speed was used as a covariate. Results: Stroke survivors demonstrated significantly slower walking speeds compared to control participants (0.6 km/hr Conclusions: The study demonstrates that treating the non-paretic leg as a healthy limb is inadequate and shows the necessity for rehabilitation approaches that target both legs individually. Focusing on motor control and force steadiness instead of simply strength can more effectively reduce maladaptive variability and enhance safe and efficient walking patterns.