Characteristics of Voluntary-induced Stepping Response in Persons with Stroke compared with those of healthy Young and Older Adults

Abstract Background Impairment of protective steps to recover balance from external perturbation is evident after stroke. Voluntary-induced stepping response (VSR) can be used to practice protective steps by instructing an individual to voluntarily lean their whole body forward until they perceive a loss of balance and automatically induce a step. However, to improve protective stepping performance, detailed characteristics of VSR in healthy persons are required. Research question What is the difference in VSR between healthy and persons with stroke? Methods An observational study was conducted in 30 participants, (10 young, 10 older, and 10 persons with stroke). All participants performed VSR for 10 trials. Step length, step width, step duration, CoM position, CoM velocity, trunk-hip displacement, and strategies of response were recorded using a motion capture system and analysed using Matlab software. Statistical analysis was performed using One-way ANOVA and Chi-square. Results On average, participants with stroke had shorter step lengths and step durations than young and older adults. Step width of older adults and participants with stroke was wider than that of young adults (p  Significance Values obtained from healthy groups can be used as guidelines to set realistic goals during VSR training to improve protective steps in patients with stroke.