CHAPTER 3
 THE IMPACT OF POST-STROKE GAIT VELOCITY CHANGES ON
 ACTIVITY AND PARTICIPATION

 Introduction

 The American Heart Association reports that 700,000 people sustain a stroke

annually [159]; it is the primary cause of adult disability [2-4]. Stroke related deficits

include motor, sensory, and cognitive impairments that negatively influence mobility.

Losses in mobility are often reflected by declines in gait velocity [40, 210]. Mobility

impairments and changes in gait velocity are related to losses of independence and

decreased ability to reengage in the community [9].

 Gait speed is an important clinical and research outcome measure. It is a common

measure of mobility and a reliable, valid, and sensitive measure of post-stroke locomotor

recovery [9, 39]. It discriminates the effects of stroke and is related to the potential for

rehabilitation recovery [40]. Gait velocity is a predictor of health status and health care

utilization in the elderly [41]. It is associated with performance of activities of daily

living (ADLs) and community ambulation [9, 10, 184].

 Potter et al. determined a relationship between gait speed and ADL performance in

the community dwelling elderly [184]. Participants with multiple diagnoses were

included and those with decreased gait speed demonstrated decreased independence. A

gait speed less than 0.25 meters per second (m/s) was associated with dependence in one

or more ADL; only 36% of those with gait speed less than 0.25 m/s were considered