The cutoff value for independent gait based on Stride Time Variability in individuals with stroke: A cross-sectional study

BACKGROUND: Patients with stroke often exhibit gait instability due to motor paralysis and balance impairments, which can hinder independent gait. Reduced independent gait is associated with an increased risk of falls, highlighting the importance of accurate assessment. Stride Time Variability (STV) is a widely used metric for evaluating gait stability, with higher values indicating greater instability. However, the relationship between STV and independent gait, as well as clinically meaningful cutoff values, has not been fully clarified. PURPOSE: This study aimed to examine the association between STV and independent gait in patients with stroke and to determine a clinically applicable cutoff value. METHODS: This cross-sectional study included 92 patients with stroke. Participants were classified into independent gait and non-independent gait groups based on their scores on the locomotion item of the Functional Independence Measure. During gait, STV was assessed using foot-mounted accelerometers. Additional evaluations included the Fugl-Meyer Assessment, Berg Balance Scale, Timed Up and Go test, and Maximum Walking Speed. Statistical analyses included between-group comparisons, logistic regression analysis, and receiver operating characteristic(ROC)curve analysis. RESULTS: = .044).The ROC analysis yielded an area under the curve of 0.742, with an optimal STV cutoff value of 3.5% (sensitivity: 68%; specificity: 73%). CONCLUSION: The study sample consisted of relatively high-functioning stroke patients, and STV was shown to be an objective indicator associated with independent gait. The proposed 3.5% cutoff value may help distinguish independent gait within this population and could serve as a supportive tool in clinical assessment.