Measures of Bipedal Toe-Ground Clearance Asymmetry to Characterize Gait in Stroke Survivors

Abstract

Post-stroke hemiparesis often impairs gait and increases the risks of falls. Low and variable Minimum Toe Clearance (MTC) from the ground during the swing phase of the gait cycle has been identified as a major cause of such falls. In this paper, we study MTC characteristics in 30 chronic stroke patients, extracted from gait patterns during treadmill walking, using infrared sensors and motion analysis camera units. We propose objective measures to quantify MTC asymmetry between the paretic and non-paretic limbs using Poincaré analysis. We show that these subject independent Gait Asymmetry Indices (GAIs) represent temporal variations of relative MTC differences between the two limbs and can distinguish between healthy and stroke participants. Compared to traditional measures of cross-correlation between the MTC of the two limbs, these measures are better suited to automate gait monitoring during stroke rehabilitation. Further, we explore possible clusters within the stroke data by analysing temporal dispersion of MTC features, which reveals that the proposed GAIs can also be potentially used to quantify the severity of lower limb hemiparesis in chronic stroke.