%0 Journal Article
%T Pathophysiological and motor factors associated with collision avoidance behavior in individuals with stroke.
%A Muroi D
%A Ohtera S
%A Saito Y
%A Koyake A
%A Higuchi T
%J NeuroRehabilitation
%V 52
%N 2
%D 2023
%M 36278363
%F 1.986
%R 10.3233/NRE-220174
%X <B>BACKGROUND: </B>High collision rates and frequency of entering the opening from non-paretic sides are associated with collision in individuals with stroke.<BR><B>OBJECTIVE: </B>To identify factors associated with collision avoidance behavior when individuals with stroke walked through narrow openings.<BR><B>METHODS: </B>Participants with subacute or chronic stroke walked through a narrow opening and had to avoid colliding with obstacles. Multiple regression analyses were conducted with pathophysiology, motor function, and judgment ability as predictor variables; collision rate and frequency of entering the opening from non-paretic sides were outcome variables.<BR><B>RESULTS: </B>Sixty-one eligible individuals with stroke aged 63±12 years were enrolled. Thirty participants collided twice or more and 37 entered the opening from the non-paretic side. Higher collision occurrence was associated with slower Timed Up and Go tests and left-right sway (odds ratios, 1.2 and 5.6; 95% confidence intervals, 1.1-1.3 and 1.3-28.2; p = .008 and.025, respectively). Entering from non-paretic sides was associated with lesions in the thalamus, left-sided hemiplegia, and Brunnstrom stage 3 or lower (odds ratios, 6.6, 8.7, and 6.7; 95% confidence intervals, 1.3-52.5, 2.5-36.5, and 1.2-57.5; and p = .038,.001, and.048, respectively).<BR><B>CONCLUSIONS: </B>Walking ability is associated with avoiding obstacle collision, while pathophysiological characteristics and degree of paralysis are associated with a preference for which side of the body enters an opening first. Interventions to improve walking ability may improve collision avoidance. Avoidance behavior during intervention varies depending on the lesion position.