Abstract

Most strokes cause severe gait impairments due to disruptions in the various mechanisms controlling gait. This narrative review describes the classification and contribution of these mechanisms in stroke patients, synthesizing recent evidence published from 2014 through 2024. Central control mechanisms reviewed will include the roles of the motor cortex, corticospinal tract, basal ganglia, and cerebellum, focusing on how damage to these areas affects gait. It also covers peripheral mechanisms, including muscle weakness, joint contractures, spasticity, and sensory nerve damage, and their influence on gait performance. Sensory feedback systems are also discussed, such as proprioceptive, visual, and vestibular inputs, in relation to their influence on gait stability and adaptation. This review collates findings from recent research with a view to providing an overview of how such disruptions in these mechanisms contribute to gait abnormalities in stroke patients, with an emphasis on targeted rehabilitation strategies which could hope to address such issues.

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