Intersegmental coordination of gait after hemorrhagic stroke.

Abstract

We compared gait using the planar law of intersegmental coordination between 14 hemorrhagic stroke subjects walking at a self-selected normal speed (56 ± 21 cm/s) and 15 age-matched healthy controls walking at a very slow speed (56 ± 19 cm/s). Sagittal plane elevation angles of the thigh, shank, and foot segments were submitted to principal component analysis. Additional outcome measures included the range of elevation angle and timing of peak elevation angle of the thigh, shank, and foot segments. The range of elevation angles at the shank and foot was significantly smaller in the paretic leg than non-paretic and control legs. Also, the peak elevation angle at the thigh occurred significantly later in the gait cycle in the paretic than control leg. Gait of both stroke and control subjects followed the planar law with the first two principal components explaining approximately 99% of the variance. However, the three-dimensional trajectory of elevation angles (gait loop) in stroke subjects deviated from the typical teardrop shape bilaterally, which was more exaggerated in the paretic leg. Compared to the non-paretic and control legs, the paretic leg showed significantly increased absolute loading of the thigh elevation angle and decreased absolute loadings of the shank and foot elevation angles on the first principal component, whereas the opposite was observed for the second principal component. Despite following the planar law, the gait of chronic stroke subjects is characterized by atypical timing of the thigh motion and disrupted intersegmental coordination of both legs.