Abstract
To investigate whether a simple observational tool may be a substitute to the time-consuming and costly 3-dimensional (3D) analysis, the study applied the Wisconsin Gait Scale (WGS), enabling assessment which is highly consistent with 3D gait parameters in patients after a stroke. The aim of this study was to determine whether, and to what extent, observational information obtained from WGS-based assessment can be applied to predict results of 3D gait analysis for selected symmetry indicators related to spatiotemporal and kinematic gait parameters. Fifty patients at a chronic stage of recovery post-stroke were enrolled in the study. The spatiotemporal and kinematic gait parameters were measured using a movement analysis system. The symmetry index (SI), was calculated for selected gait parameters. The patients’ gait was evaluated by means of the WGS. It was shown that stance % SI, as well as hip and knee flexion-extension range of motion SI can most effectively be substituted by WGS-based estimations (coefficient of determination exceeding 80%). It was shown that information acquired based on the WGS can be used to obtain results comparable to those achieved in 3D assessment for selected SIs of spatiotemporal and kinematic gait parameters. The study confirms that observation of gait using the WGS, which is an ordinal scale, is consistent with the selected aims of 3D assessment. Therefore, the scale can be used as a complementary tool in gait assessment.
Highlights
Despite the fact that 3-dimensional gait analysis (3DGA) is the most accurate method enabling gait assessment and is recognized as a key outcome measure by gait researchers and healthcare professionals [1], for many facilities it is inaccessible due to the considerable costs involved
It can be noticed that the symmetry index (SI) is characterized by significant right-side asymmetry, which is shown by the skewness coefficient approaching or even exceeding 1 (Table 2)
The present study has a practical dimension as it confirms that the Wisconsin Gait Scale (WGS) is a valuable gait assessment tool and in the circumstances when the use of costly objective methods is not feasible, the WGS may effectively be applied as a diagnostic instrument to perform evaluation of post-stroke gait pattern asymmetry
Summary
Despite the fact that 3-dimensional gait analysis (3DGA) is the most accurate method enabling gait assessment and is recognized as a key outcome measure by gait researchers and healthcare professionals [1], for many facilities it is inaccessible due to the considerable costs involved. The WGS has been shown to be accurate and reliable in patients post-stroke, it can effectively be used to evaluate progress in gait rehabilitation after a stroke [3,4,5,6,7,8]. The WGS was intended to be used as a tool to enable the assessment of effects achieved during a home-based gait training program designed for patients at a chronic stage of recovery post-stroke [3]. Pizzi et al [6] reported that the WGS may be used effectively to evaluate qualitative changes in gait patterns presented by patients with post-stroke hemiparesis, and to assess changes observed during the course of long-term rehabilitation. The tool may be effectively applied effectively when it is necessary to perform targeted and standardized measurements of hemiplegic gait in order to accurately modify rehabilitation in line with the results of monitoring [6]
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