A Review of the Physical Demands of Stair Negotiation in Healthy Aging and Following Stroke

Stair negotiation is an important determinant of community ambulation and functional independence. Compared to level ground walking, the ability to manage stairs requires greater joint range of motion, muscle strength and cardiovascular fitness which can pose challenges for older adults secondary to age-related decline in physical capacity. For older adults who have experienced a stroke, the superimposition of the resultant physical impairments can further compromise mobility and may limit the capacity for community ambulation risking social isolation. This paper summarizes the research describing the lower limb joint mobility, the muscle moment requirements, and the oxygen demands of stair negotiation relative to level walking to characterize the physical ‘costs’ of mobility essential for community ambulation. Specifically, alterations in movement patterns due to age-related changes in physical capacity are discussed in the context of better understanding the impact of stroke-related impairments on the ability to compensate in order to negotiate stairs. This information is relevant to physical rehabilitation specialists to assist in determining individuals’ capacity for community ambulation and to provide guidance in developing targeted strategies to enhance mobility in people aging with stroke.