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Paper text:
about 60% of stroke patients experience posture and balance problems during gait1 . generally , they prefer to use the less 
 affected side than the affected side for weight - bearing load during gait .
this can lead to 
 an asymmetric body posture , and the development of abnormal weight shifting in gait1 .
these conditions can limit the motion of 
 stroke patients , and increase their risk of falls2 .
when stroke patients return to their homes , about 56% of them 
 experience falls within 2 months3 .
such 
 falls can lead to the development of secondary impairments and disability in the nervous 
 system and orthopedic problems . according to a previous study ,
stroke patients may have 
 problems with the quality of their gait cycle ( e.g. , gait speed , poor endurance , reduced 
 quality , and adaptability in walking patterns , and coordination of the legs)4 .
also , these conditions cause deceleration 
 control to increase , while acceleration control decreases during gait . again
, this can be 
 lead to increased compensatory movements and asymmetric gait patterns4 , 5 .
consequently , 
 these gait problems can result in balance impairment , and then falls .
previous studies have 
 demonstrated that stroke patients have increased fear or anxiety during gait , and a high 
 level of anxiety increases the risk of depression .
many studies have 
 demonstrated a relationship between falls and quality of life , even though they did not 
 compare gait parameters with psychological aspects , such as fall anxiety .
thus , in this 
 study , we investigated the gait parameters and fear and anxiety of stroke patients .
twelve patients with stroke ( mean age : 50.7511.07  years ; five females , seven males ) 
 participated in this study .
the inclusion criteria were a history of only one 
 documented stroke event , no orthopedic disease , a mini - mental state examination score above 
 25 , and the ability to walk more than 10  m without a cane .
the biodex gait trainer 2 is a 
 device which is used to assess and train the walking performance of patients with neurologic 
 gait dysfunction .
it consists of a treadmill with an instrumented deck that monitors and 
 records kinematic gait parameters including gait speed , step cycle , step length , and time on 
 each foot ( step symmetry ) .
lachman et al.7 developed the  survey of activities and fear 
 of falling in the elderly  ( safe ) measure that assesses fear of falling and also provides an 
 index of activity avoidance due to fear .
responses use a four - point likert scale ( 1 = not at 
 all sure to 4 = very sure ) .
gait analysis was performed on the biodex gait trainer 2 for 
 5  min .
characteristic gait parameters , including differences between the affected and 
 unaffected sides , were assessed .
all subjects walked on the gait trainer treadmill at a 
 speed of 3  km / h wearing normal shoes . before the experiment , they received instructions 
 concerning the test procedure and walked for 3  min as a warm up and to adapt to the step 
 speed and equipment .
we told the subjects that they should try to maintain a comfortable 
 gait speed , continuously .
22.0 ; 
 spss inc . , chicago , il , usa ) was used to analyze correlations between gait parameters and 
 fear of falling .
comparisons of correlations between gait parameters and fear of falling 
 were assessed using spearman s rank correlation test .
correlation between gait parameters and fear of falling scores were calculated . a moderate 
 degree of correlation between fear of falling score and the step cycle item of gait 
 parameters was found ( p < 0.05 ) .
no other gait parameter showed a significant degree of 
 correlation with the fear of falling score ( p > 0.05 ) ( table 1table 1.correlation of gait parameters and fall anxiety ( n=12)gait parametersgait speedstep cyclestep length(affected)step length(unaffected)time on each foot(affected)time on each foot(unaffected)safe0.4320.581*0.1120.0700.2890.289 ) .
many stroke patients feel a sense of loss over problems of gait ability . indeed , gait 
 disability can limit the independent living of stroke patients8 .
many stroke survivors have a hard time maintaining their balance 
 due to decreased weight shifting ability and stability8 .
a previous study found that gait patterns of stroke patients are 
 slow and require excessive effort , and the patients showed uncoordinated movements in both 
 legs1 .
it has also been demonstrated 
 that gait speed is related to the ability to maintain balance .
patients with balance 
 impairment show increased feet support time , and reduction in gait speed is a risk for 
 falls , increasing anxiety9 .
our study 
 confirmed the possibility that certain gait parameters are associated with increased fear 
 and anxiety .
we found a moderate degree of correlation between the fear of falling score and 
 the step cycle .
a previous study demonstrated that the slow gait speed phenomenon was 
 related to a decrease in cadence and a shortened stride length .
moreover , compared with 
 healthy people , stroke patients show decreased cadence and increased gait cycles , which lead 
 to an increased double - stance phase and stance phase of the unaffected side leg4 .
indeed , our study showed that a decreased 
 step cycle was associated with fear of falling scores , indicating that a decreased step 
 cycle leads to increased fear of falling during gait .
it can be demonstrated that 
 asymmetrical limb support slows the step cycle10 , 
 11 .
we hypothesize that one cause of 
 this is the development of abnormal weight shifting in the step cycle , which makes subjects 
 feel uneasy about falling10 , 11 .
generally , the step cycle is considered to be a temporal 
 gait parameter10 , 11 .
thus , we suggest that temporal parameters are likely to be more 
 closely related to falling anxiety than spatial gait parameters .
moreover , problems with 
 functional independence skills affect the quality of life of stroke patients .
mence12 indicated that people with stroke could 
 feel joy just by walking in the street .
thus , enhancing gait ability is an important means 
 of improving the lives of stroke patients .
[ purpose ] the purpose of this study was to assess the correlation of gait parameters with 
 fear of falling in stroke survivors . 
 [ subjects ] in total , 12 patients with stroke 
 participated . 
 [ methods ] the subjects performed on a biodex gait trainer 2 for 5  min to 
 evaluate characteristic gait parameters . 
 the kinematic gait parameters measured were gait 
 speed , step cycle , step length , and time on each foot ( step symmetry ) . 
 all the subjects 
 also completed a fall anxiety survey . 
 [ results ] correlations between gait parameters and 
 fear of falling scores were calculated . 
 there was a moderate degree of correlation between 
 fear of falling scores and the step cycle item of gait parameters . 
 [ conclusions ] according 
 to our results , the step cycle gait parameter may be related to increased fall 
 anxiety .