Gait Characteristics in Acute Stroke and Transient Ischemic Attack Measured with Accelerometers

Abstract

Gait impairments are a well-documented consequence of stroke, yet the impact of transient ischemic attack (TIA) on gait remains underexplored. This study aimed to characterize acute changes in gait patterns within three days of stroke or TIA onset using an accelerometer, and to examine the relationship between gait patterns and questionnaire-based measures of balance confidence. We found that patients with TIA showed significantly lower variability in swing time, stance time, and step time than patients with stroke. Comparisons between patients with TIA and controls indicated that controls had higher mean step velocity and lower step time asymmetry. Additionally, compared with controls, patients with stroke demonstrated a slower and less temporally consistent pace, indicated by shorter step length, lower step velocity, and higher standard deviation (SD) for swing time, stance time, and step time. They also showed greater variability, reflected by higher step length SD, and more pronounced gait asymmetry, with greater asymmetry in swing time, step time, and stance time. The balance confidence was associated with gait parameters in patients with stroke and in controls, but not in patients with TIA. In both groups, higher confidence related to longer step length and faster step velocity; in stroke it was also linked to lower swing time variability and longer step and stance times, and in controls to lower step time variability. These findings demonstrate that TIA involves detectable neurological changes affecting motor control, highlighting the value of detailed accelerometer-based gait analysis for early detection of functional deficits.