Stroke survivors often face difficulty in community ambulation though they attain steady-state walking in clinical setups. Compliance and unpredictability of the environment may alter the muscle activity and challenge the individual's gait. Successful reintegration into the community requires gait assessment and training in a real-life challenging environment. Little is known about the assessment and training of gait in the community environment under challenging mobility dimensions. Hence, we aimed to study the changes that real-life environmental dimensions have on the activity of selected muscles in hemiparetic lower limb and gait velocity in stroke survivors. Methods: An observational cross-sectional study was conducted on 16 ambulatory stroke survivors to assess the hemiparetic lower limb muscle activity during walking in real-life environmental dimensions. Participants were made to walk in the community on a walkway consisting of even surface, ramp, stairs, uneven terrain and obstacles. They were also made to manoeuvre through traffic and pick a load while walking for a distance in the walkway. Muscle activity of Rectus Femoris, Biceps Femoris, Gastrocnemius Medialis and Tibialis Anterior of the paretic lower limb were continuously recorded while walking using wireless surface electromyography. Gait velocity for the entire walkway and level of perceived difficulty while walking in different dimensions were also measured. Paired t-test was used to compare the percentage Maximum Voluntary Contraction (%MVC) of lower limb muscles between even surface and real-life environment dimensions while walking. One sample t-test was used to compare the gait velocity in real-life dimensions versus gait velocity in even surface measured in an earlier study. Results: There was a significant reduction (p < 0.01) in the activity of all four hemiparetic lower limb muscles while walking under the influence of real-life environmental dimensions compared to even surface. Gait velocity (0.33 ± 0.17 m/s) was significantly lower than that is essential to be a community ambulator. The level of perceived difficulty across all dimensions was reported qualitatively with the highest difficulty reported during stair and obstacle clearance. Conclusion: Real-life environmental dimensions lead to the reduction of paretic lower limb muscle activities and gait velocity during walking in community-dwelling stroke survivors. Stroke survivors perceived more difficulty while walking in real-life environment dimensions particularly while negotiating stairs and obstacles. Significance: Knowledge about the influence of real-life environmental dimensions will help the clinicians to target rehabilitation methods to improve walking adaptability.

尽管中风幸存者在临床环境中能够达到稳定的行走状态，但他们通常在社区行走方面面临困难。环境的依从性和不可预测性可能会改变肌肉活动并挑战个人的步态。成功融入社区需要在现实生活中充满挑战的环境中进行步态评估和培训。在具有挑战性的移动维度下，对于社区环境中步态的评估和训练知之甚少。因此，我们旨在研究现实环境尺寸对中风幸存者偏瘫下肢所选肌肉活动和步态速度的影响。方法：对16名非中风幸存者进行了一项观察性横断面研究，以评估在现实环境中行走过程中下腹部下肢肌肉活动的情况。参与者被要求在平坦的地面，坡道，楼梯，不平坦的地形和障碍物组成的人行道上在社区中行走。他们还被要求在交通中移动并在人行道上行走一定距离时捡起重物。使用无线表面肌电图走路时连续记录腓肠直肌，股二头肌，腓肠肌和胫骨前臂的肌肉活动。还测量了整个人行道的步态速度以及在不同维度上行走时感知到的困难程度。配对t检验用于比较行走时在均匀表面和实际环境尺寸之间下肢肌肉的最大自愿收缩百分比（％MVC）。一项样本t检验用于比较现实生活中的步态速度与在较早的研究中测得的平坦表面中的步态速度。结果：与真实表面相比，在现实环境尺寸的影响下行走时，所有四个半肝下肢肌肉的活动均显着降低（p <0.01）。步态速度（0.33±0.17 m / s）明显低于成为社区步行者所必需的速度。定性报告了在各个维度上感知到的困难程度，在楼梯和障碍物清除过程中报告了最高难度。结论：在社区居住的卒中幸存者中，现实生活中的环境维度导致步行过程中下肢肌肉活动减少和步态速度降低。中风幸存者在现实环境中行走时尤其是在谈判楼梯和障碍物时感觉到更多困难。启示：了解现实生活中环境因素的影响将有助于临床医生确定康复方法，以改善步行适应性。