Abstract
We aimed to investigate whether a newly defined distance in the lower limb can capture the characteristics of hemiplegic gait compared to healthy controls. Three-dimensional gait analyses were performed on 42 patients with chronic stroke and 10 age-matched controls. Pelvis-toe distance (PTD) was calculated as the absolute distance between an anterior superior iliac spine marker and a toe marker during gait normalized by PTD in the bipedal stance. The shortening peak during the swing phase was then quantified as PTDmin. The sagittal clearance angle, the frontal compensatory angle, gait speed, and the observational gait scale were also collected. PTDmin in the stroke group showed less shortening on the affected side and excessive shortening on the non-affected side compared to controls. PTDmin on the affected side correlated negatively with the sagittal clearance peak angle and positively with the frontal compensatory peak angle in the stroke group. PTDmin in stroke patients showed moderate to high correlations with gait speed and observational gait scale. PTDmin adequately reflected gait quality without being affected by apparent improvements due to frontal compensatory patterns. Our results showed that various impairments and compensations were included in the inability to shorten PTD, which can provide new perspectives on gait rehabilitation in stroke patients.
Highlights
Hemiplegic gait resulting from stroke often leads to a characteristic motion pattern and abnormal muscle activity, with a variety of abnormal joint trajectories [1]
Well-functioning cases in the stroke group displayed no frontal compensatory pattern, PTDmin was slightly deficient on the affected side
In cases with low Fugl-Meyer Assessment Lower Extremity Subscale (FMA-LE), the frontal clearance (FC) peak increased in a trade-off relationship with the decrease in the sagittal clearance (SC) peak, compensating for the lack of PTDmin
Summary
Hemiplegic gait resulting from stroke often leads to a characteristic motion pattern and abnormal muscle activity, with a variety of abnormal joint trajectories [1]. Common features during the swing phase include decreased peak hip flexion, peak knee flexionextension, and dorsiflexion [2,3]. These abnormal motion patterns primarily lead to a lack of foot-floor clearance and may result in compensatory motion patterns [4,5]. Divergence between kinematic patterns and gait performance (including gait speed) has been shown in functional recovery after stroke [7,8]. Quantifying the distance factor between coordinates to quantify joint trajectories in 3-dimensional space may facilitate our understanding of gait
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