The provision of a cane provides greater benefit to community-dwelling people after stroke with a baseline walking speed between 0.4 and 0.8 metres/second: an experimental study

Objective To investigate the effect of the provision of a cane on walking ability in ambulatory people with chronic stroke. Design Experimental study. Setting Clinics within the community. Participants Twenty-four people on average 6 years after a stroke, who were not regular users of walking sticks. Participants were categorized as slow (<0.4 metres/second), intermediate (0.4-0.8 metres/second), or fast walkers (>0.8 metres/second) on the basis of their baseline walking ability. Experimental conditions Walking with and without a cane. Main outcome measures Walking ability was measured using the 10-m Walk Test and reported as speed (metres/second), step length (metres), and cadence (steps/minute). Results Overall, the provision of a cane produced no significant change in speed (0.05 metres/second, 95% CI -0.01 to 0.11) or cadence (-3 steps/minute; 95% CI -8 to 3), but a small increase in step length (0.04 metres, 95% CI 0.03 to 0.06). For the intermediate walkers, the cane increased speed by 0.18 metres/second (95% CI 0.11 to 0.24), step length by 0.07 metres (95% CI 0.05 to 0.09), but not cadence. The provision of a cane to the intermediate walkers also produced 0.27 metres/second (95% CI 0.18 to 0.36) more increase in speed compared with the fast walkers, and 0.12 metres/second (95% CI 0.03 to 0.21) more increase compared with the slow walkers. Conclusion The provision of a cane produced most benefit to a subgroup of intermediate walkers in a group of community-dwelling people with chronic stroke whose walking had stabilized, without detriment to quality of walking. (C) 2016 Published by Elsevier Ltd on behalf of Chartered Society of Physiotherapy.