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Walking function in those who have sustained a stroke may range from complete dependence to independent walking ability. During the first week after a stroke, only a third of persons are able to walk unaided [3] but at 3 weeks or at hospital discharge 50�C80% of survivors can walk unaided [4, 5] and by 6 months approximately 85% of stroke survivors are able to walk independently without physical assistance from another person [6]. Interestingly, while up to 85% of individuals INSRR with a stroke regain independent walking ability [6�C8], only about 7% of persons discharged from inpatient rehabilitation could manage steps and inclines and walk the speeds and distances required to walk competently in the community [8�C10]. Walking in everyday life necessitates walking adaptability, which is the ability to modify walking to meet behavioral task goals and demands of the environment [11�C13]. The ability to adapt walking is one component of a tripartite model of locomotor control, along with the ability to generate stepping and maintain postural equilibrium PF-05212384 order [11, 14]. Individuals with limited ability to appropriately adjust to changes in the task and environment may either choose to avoid walking in these contexts (a safety strategy) or experience a heightened risk of falls when required to walk under these challenging circumstances [15]. Indeed, the rates of falling are reported to be high, ranging between 23�C34%, 40�C73%, and 43�C70% during a 3-4 month [7, 16], 6-month [17, 18], and 1-year follow-up [19, 20], respectively. Most falls are reported to result from a trip, a slip, or a misplaced step while walking [17, 21�C24] and walking is also the most frequently Fostamatinib order reported activity (39%�C90%) at the time of a fall in stroke survivors [7, 17, 25, 26], suggesting the reduced ability of individuals with stroke to adjust walking to task and environmental demands. Despite the relevance of walking adaptability to everyday mobility and the reduced ability of individuals with stroke to adjust walking to task and environmental demands, assessment of walking adaptability has received relatively little attention. Frequently used assessments of walking recovery after stroke involve walking short distances (such as the 10m walking speed test, timed up, and go test) and examination of isolated limb movements (e.g., Fugl-Meyer Assessment) to predict walking recovery [27�C29]. Although valuable, these assessments do not account for the full repertoire of walking skills that are required to reengage in safe and independent ambulation in the home and community [29, 30]. Specific, comprehensive, and rigorous assessments for walking adaptability are essential to design targeted interventions to improve walking adaptability after stroke.
