Post-stroke Hemiplegic Patients Research Articles

Trunk Movement Characteristics of Post-stroke Hemiplegic Patients at Gait Initiation

Trunk Movement Characteristics of Post-stroke Hemiplegic Patients at Gait Initiation

The time-varying networks of the wrist extension in post-stroke hemiplegic patients.

The online version contains supplementary material available at 10.1007/s11571-021-09738-2.

Functional Muscle Network in Post-stroke Patients during Quiet Standing.

The overall muscle activation of post-stroke patients during standing has not been well understood. Functional muscle network provides a tool to quantify the functional synchronization across a large number of muscles. In order to investigating the functional muscle network of stroke survivors during quiet standing, we recruited 8 post-stroke hemiplegic patients and required them to stand still for 30 s with eyes open and closed. Surface electromyography signals were recorded from 16 muscles in abdomen, buttocks and lower limbs. The functional muscle networks of paretic side and healthy side were built by multiplex recurrence network approach. The topological characteristics of functional muscle network was quantified by parameters of multiplex network and weighted network. The results showed that the dynamical similarities of muscles on paretic side were reduced, and the dynamical connections of muscles on paretic side were weakened. Without visual feedback, the muscles activated in a more similar mode. The stroke led to lower synchronization of the muscle activation, and decreased efficiency of information transmission between muscles. When subjects stood with eyes closed, the muscles activated in a more deterministic pattern. The research opens new horizons to detect the overall muscle activation when stroke patients stand quietly, and can provide a theoretical basis for understanding the motor dysfunction caused by stroke.

EFFECT OF VIBRATION STIMULUS ON SPASTICITY IN POST STROKE HEMIPLEGIC PATIENTS

Physical treatment such as vibration has been proposed as possible non-pharmacological way to control spasticity. The aim of the study was 1) can a selective vibration of the lower limb Dorsiexors of foot and quadriceps, reduce the spasticity of the plantar exors and hamstrings muscle; 2) is vibrations association with physiotherapy better than physiotherapy alone in reducing spasticity. This was a Pre Post study design wherein all the patients were taken from OPD in Govt. Medical College & Hospital, Sector 32 Chandigarh, India. Atotal of Sixty post stroke hemiplegic patients were taken for the study. Method. (VIB + PT) group A received physiotherapy plus vibration by means of a hand held vibrator applied over the belly of the Dorsiexors of leg and belly of Quadriceps muscle of the spastic side (contact surface 2 cm2; frequency 100 Hz; amplitude 2 mm; mean pressure 250 mBar). Control group B received conventional physiotherapy treatment alone. Both groups had 45 minutes of physiotherapy including Bobath therapy, muscle lengthening stretching exercises for 5 days a week for 2 weeks.Main Outcome Measure was Spasticity measurement by Modied Ashworth scale for both the groups before starting treatment and after the end of 2 weeks. Results: Fisher's exact test showed a statistically non signicant improvements in the (VIB + PT) group (p≥0.05) compared to in the (PT) group after 2 weeks of treatment for the Modied Ashworth scale. AlthoughStuart Maxwell Test showed that there was a statistically signicant difference within Group A i.e. Vibration plus Conventional physiotherapy with (p≤0.05) Conclusion. 1) 100 Hz vibration applied to the Dorsiexors of foot and Quadriceps muscle of a spastic lower limb in association with physiotherapy is able to reduce the spasticity of the exor agonist i.e. plantar exors and hamstrings 2) this association is not better than physiotherapy alone in controlling spasticity. Clinical Rehabilitation Impact :100 Hz antagonist muscle vibration, a non-pharmacological treatment, can help physiotherapy to reduce exors spasticity in the rehabilitation of lower limb spasticity.

DNN-Based FES Control for Gait Rehabilitation of Hemiplegic Patients

In this study, we proposed a novel machine-learning-based functional electrical stimulation (FES) control algorithm to enhance gait rehabilitation in post-stroke hemiplegic patients. The electrical stimulation of the muscles on the paretic side was controlled via deep neural networks, which were trained using muscle activity data from healthy people during gait. The performance of the developed system in comparison with that of a conventional FES control method was tested with healthy human subjects.

Measurements of the centre of pressure of individual legs reveal new characteristics of reduced anticipatory postural adjustments during gait initiation in patients with post-stroke hemiplegia.

ObjectivesTo determine whether individual measurements of the centre of pressure for the stance and stepping legs can reveal new characteristics of reduced anticipatory postural adjustments during gait initiation in post-stroke hemiplegic patients.MethodsSubjects included 30 stroke patients and 10 healthy age-matched controls. The acceleration of the trunk, and the centre of pressure of each leg, were measured during gait initiation, 3 times each with the paretic and non-paretic legs leading. Anticipatory postural adjustments were characterized using trunk acceleration and centre of pressure displacement data.ResultsLatency of the posterior displacement peak of the paretic leg centre of pressure with either the paretic or non-paretic leg leading was significantly longer in stroke patients compared with controls, and was also longer than that of the non-paretic leg. The magnitude of the posterior displacement peak of the paretic leg centre of pressure was smaller than that of the non-paretic leg. Peak latency of the paretic stepping leg centre of pressure correlated with the clinical measures of motor dysfunction, postural balance, and gait ability.ConclusionMeasurements of the latency and magnitude of centre of pressure displacement peak individually for the paretic and non-paretic legs can help elucidate the mechanism behind reduced anticipatory postural adjustments. This information will be useful in designing new treatment strategies for stroke patients.LAY ABSTRACTMeasuring the centre of pressure individually for the stance and stepping legs can reveal what happens during initiation of gait in stroke patients. The latency and magnitude of the centre of pressure displacement peak showed characteristic differences between stroke patients and control subjects, and between paretic and non-paretic legs. The peak latency of the paretic stepping leg centre of pressure correlated significantly with clinical measures of motor dysfunction, postural balance, and gait ability. These findings may contribute to the development of effective rehabilitation exercises for stroke patients.

Classification of abnormal gait patterns of poststroke hemiplegic patients in principal component analysis.

The objective of this study was to classify the 10 types of characteristic abnormal gait by principal component analysis using quantitative indices of 10 types of abnormal gait. For abnormal gait pattern classification, principal component analysis was performed using the deviation values of the 10 types of abnormal gait of 90 subjects. Scatter plots of the factor loadings of the 1st and 2nd principal components of the 10 types of abnormal gait were prepared, and those arranged at near sites were grouped based on the positional relationship, through which abnormal gait patterns were classified. It was suggested that abnormal gait patterns can be classified into insufficient knee flexion, hip hiking, and excessive lateral shift of the trunk over the unaffected side in the swing phase; knee extensor thrust pattern accompanying forefoot contact in the stance phase in addition to circumduction gait of the swing phase; and flexed knee gait pattern accompanying retropulsion of the hip in addition to median whip in the stance phase and excessive hip external rotation in the swing phase. It was clarified by these principal component analyses that information contained in the results of the 10 quantitative indices of abnormal gait of the 90 poststroke hemiplegia patients was compressed into several abnormal gait patterns. If observational abnormal gait analysis is performed after understanding this gait pattern classification, it may help improve the accuracy of gait analysis by observation.

The Effectiveness of Combined Mental Practice and Conventional Physiotherapy for the Improvement of Upper Extremity Function and Activity of Daily Performance in Post-stroke Hemiplegic Patients: A Comparative Study

The Effectiveness of Combined Mental Practice and Conventional Physiotherapy for the Improvement of Upper Extremity Function and Activity of Daily Performance in Post-stroke Hemiplegic Patients: A Comparative Study

Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients

Many poststroke hemiplegic patients have an asymmetrical wheelchair-sitting posture. This study aimed to investigate the impact of different back support shapes on asymmetrical sitting posture and pressure points among poststroke hemiplegic patients during an activities of daily living–related reaching task. This study included 23 poststroke hemiplegic patients who performed tasks that involved the movement of objects using the unaffected upper limb to the affected side while sitting in a conventional wheelchair (C-WC) with a flat back support or a wheelchair providing pelvic and thoracic support (P-WC). Body alignment angles from video images and pressure distribution on supporting surfaces were measured using a two-dimensional motion analysis software (Dartfish) and a pressure mapping system (FSA). Regarding movement performance, although postural asymmetry increased in both wheelchair types, the degree of postural variation was smaller with P-WC use than C-WC use (p < 0.05), with partly reduced postural asymmetry. With P-WC, one-sided ischial asymmetrical pressure was significantly less after the movement (p < 0.05). In conclusion, P-WC’s back support shape contributed to a decrease in postural asymmetry for pelvic girdle support both at rest and during movement. This highlights the importance of a wheelchair back support shape and may help to increase the quality of activities of daily living movement in poststroke hemiplegic patients in wheelchairs.

Acupuncture for poststroke hemiplegia focusing on cerebral bilateral connections: study protocol for a randomised controlled neuroimaging trial

IntroductionAcupuncture is safe and effective for improving the motor function of poststroke hemiplegic patients, but there still exists a certain gap between clinical practice and understanding its neural mechanisms. The...

Abstract WP200: Robot-assisted Arm Training in Subacute Hemiplegic Stroke Patients

Background and Aims: Robotic rehabilitation therapy has been tried as a novel technology in field of upper extremity rehabilitation of stroke patients. However, the previous trial revealed the additional effect of robotic therapy compared to conservative therapy. We aimed to investigate whether the same intensity robot-assisted arm training(RAT) was more effective on the recovery of motor and improvement of upper limb function than conventional occupational therapy(COT) in subacute first-ever hemiplegic stroke patients (Fig.1). Methods: The clinical assessment included Fugl-Meyer Assessment(FMA), Motricity Index(MI), Functional Independence Measure(FIM), Motor Function Test(MFT), Wolf Motor Function Test(WMFT), Trunk Control Test(TCT), Maximal Voluntary Torques(MVT), Visual Analogue Scale(VAS) for pain, and Active Range of Motion(AROM). The repeated measures ANOVA was used to compare the results of longitudinal analyses between two groups (SPSS Inc., Chicago, IL, USA). Results: The all parameters measured at baseline did not differ between two groups. Both groups showed significant improvements in FMA, MI, FIM, MFT, WMFT, TCT, MVT, and AROM after treatment (P&lt;0.05). However, the results of longitudinal analyses during the 8-week study period did not show significant difference between two groups except VAS in AROM (p=0.011) and AROM of shoulder adduction (p=0.032) (Table 1). Conclusions: This study did not agree that robot-assisted arm training combined with conventional occupational therapy in subacute post-stroke hemiplegic patients may be superior to the same intensity conventional occupational therapy.

Analysis of center of mass acceleration and muscle activation in hemiplegic paralysis during quiet standing.

Hemiplegic paralysis after stroke may augment postural instability and decrease the balance control ability for standing. The center of mass acceleration (COMacc) is considered to be an effective indicator of postural stability for standing balance control. However, it is less studied how the COMacc could be affected by the muscle activities on lower-limbs in post-stroke hemiplegic patients. This study aimed to examine the effects of hemiplegic paralysis in post-stroke individuals on the amplitude and structural variabilities of COMacc and surface electromyography (sEMG) signals during quiet standing. Eleven post-stroke hemiplegic patients and the same number of gender- and age-matched healthy volunteers participated in the experiment. The sEMG signals of tibialis anterior (TA) and lateral gastrocnemius (LG) muscles of the both limbs, and the COMacc in the anterior-posterior direction with and without visual feedback (VF vs. NVF) were recorded simultaneously during quiet standing. The sEMG and COMacc were analyzed using root mean square (RMS) or standard deviation (SD), and a modified detrended fluctuation analysis based on empirical mode decomposition (EMD-DFA). Results showed that the SD and the scale exponent α of EMD-DFA of the COMacc from the patients were significantly higher than the values from the controls under both VF (p < 0.01) and NVF (p < 0.001) conditions. The RMSs of TA and LG on the non-paretic limbs were significantly higher than those on paretic limbs (p < 0.05) for both the patients and controls (p < 0.05). The TA of both the paretic and non-paretic limbs of the patients showed augmented α values than the TA of the controls (p < 0.05). The α of the TA and LG of non-paretic limbs, and the α of COMacc were significantly increased after removing visual feedback in patients (p < 0.05). These results suggested an increased amplitude variability but decreased structural variability of COMacc, associated with asymmetric muscle contraction between the paretic and the non-paretic limbs in hemiplegic paralysis, revealing a deficiency in integration of sensorimotor information and a loss of flexibility of postural control due to stroke.

Effectiveness of mirror therapy in the motor recovery of upper extremity in the post stroke hemiplegic patients: a randomized controlled trial in a tertiary care hospital in Manipur, Northeast India

Background: Stroke is a leading cause of disability and majority of the stroke survivors experience upper extremity functional limitations. Therefore, the objective of this study was to evaluate the effectiveness of mirror therapy in addition with a conventional upper limb rehabilitation program in a post stroke hemiplegic patient.Methods: A randomized controlled trial was conducted among 72 post stroke patients aged 35-65 years having hemipa¬resis attending the PMR department, RIMS, Manipur from 2013 to 2016. Assessment was done at baseline, 1 and 6 months for FIM self care, Brunnstrom stages of motor recovery and MAS for spasticity. Both the group participated in a stroke rehabilitation program and study group was given mirror therapy in addition. Descriptive statistics such as mean±SD and inferential statistics like Chi-square test, Student’s t test, and ANOVA were used. A p-value &lt; 0.05 was taken as statistically significant.Results: There was an improvement in Brunnstrom stage and FIM self-care score in both groups, but the post-treatment score was significantly higher in the mirror therapy group. Statistically significant difference in FIM self care and motor recovery between the study and control groups was noted [1.1±0.38 (study) versus 0.88±0.32 (control) for motor recovery and 34.1±2.59 (study) versus 29.5±4.58 (control) for FIM self care]. However, no significant difference was seen in spasticity between the groups.Conclusions: Mirror therapy used in addition to conventional stroke rehabilitation program was found to be effective in the recovery of upper extremity motor functions and daily self care activities in post stroke hemiplegic patients.

Influence of positional changes on spasticity of the upper extremity in poststroke hemiplegic patients

BackgroundSpasticity commonly occurs in hemiplegic patients with stroke, and clinical experience indicates that upper limb spasticity is more apparent when patients are standing than when they are lying down. Few reports have investigated how positional changes impact the spasticity of the upper limb and trigger a combined movement called the “hemiplegic posture”. ObjectiveThe objective of this study was to explore the influence of different body positions on the spasticity of the upper extremity. MethodsEighty-four poststroke patients with upper limb spasticity were recruited for this study. We measured the spasticity of hemiplegic upper limbs involving elbow flexors, wrist flexors and digitorum flexors using the Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS) and Triple Spasticity Scale (TSS) in three positions, i.e., supine, sitting and standing. The results were obtained by comparing one position with another for each muscle. ResultsAll the MAS, MTS and TSS scores of all the muscles of the upper limb were significantly lower in the supine position than in the other positions (all P < 0.05), and the MTS and TSS scores were statistically higher while standing than while sitting (P < 0.05). ConclusionHigh modulation of spasticity in the upper limbs measured using the MAS, MTS and TSS when transitioning to the standing position from either the supine or sitting position demonstrated that posture plays a role in modulating the spasticity of the hemiplegic upper limb in poststroke patients.

Spasticity Assessment Based on the Maximum Isometrics Voluntary Contraction of Upper Limb Muscles in Post-stroke Hemiplegia

Background: The assessment of muscle properties is an essential prerequisite in the treatment of post-stroke patients with limb spasticity. Most existing spasticity assessment approaches do not consider the muscle activation with voluntary contraction. Including voluntary movements of spastic muscles may provide a new way for the reliable assessment of muscle spasticity.Objective: In this study, we investigated the effectiveness and reliability of maximum isometrics voluntary contraction (MIVC) based method for spasticity assessment in post-stroke hemiplegia.Methods: Fourteen post-stroke hemiplegic patients with arm spasticity were asked to perform two tasks: MIVC and passive isokinetic movements. Three biomechanical signals, torque, position, and time, were recorded from the impaired and non-impaired arms of the patients. Three features, peak torque, keep time of the peak torque, and rise time, were computed from the recorded MIVC signals and used to evaluate the muscle voluntary activation characteristics, respectively. For passive movements, two features, the maximum resistance torque and muscle stiffness, were also obtained to characterize the properties of spastic stretch reflexes. Subsequently, the effectiveness and reliability of the MIVC-based spasticity assessment method were evaluated with spearman correlation analysis and intra class correlation coefficients (ICCs) metrics.Results: The results indicated that the keep time of peak torque and rise time in the impaired arm were higher in comparison to those in the contralateral arm, whereas the peak torque in the impaired side was significantly lower than their contralateral arm. Our results also showed a significant positive correlation (r = 0.503, p = 0.047) between the keep time (tk) and the passive resistant torque. Furthermore, a significantly positive correlation was observed between the keep time (tk) and the muscle stiffness (r = 0.653, p = 0.011). Meanwhile, the ICCs for intra-time measurements of MIVC ranged between 0.815 and 0.988 with one outlier.Conclusion: The findings from this study suggested that the proposed MIVC-based approach would be promising for the reliable and accurate assessment of spasticity in post-stroke patients.

Pre-therapeutic Device for Post-stroke Hemiplegic Patients’ Wrist and Finger Rehabilitation

Background/Objectives: This paper suggests a pre-therapeutic device for post-stroke hemiplegic patients’ wrist and finger rehabilitation both to decrease and analyze their muscle tones before the main physical or occupational therapy.Method/Statistical Analysis: We designed a robot which consists of a BLDC motor, a torque sensor, linear motion guides and bearings. Mechanical structure of the robot induces flexion and extension of wrist and finger (MCP) joints simultaneously with the single motor. The frames of the robot were 3D printed. During the flexion/extension exercise, angular position and repulsive torque of the joints are measured and displayed in real time.Findings: A prototype was 3D printed to conduct preliminary experiment on normal subject. From the neutral joint position (midway between extension and flexion), the robot rotated 120 degrees to extension direction and 30 degrees to flexion direction. First, the subject used the machine with the usual wrist and finger characteristics without any tones. Second, the same subject intentionally gave strength to the joints in order to imitate affected upper limb of a hemiplegic patient. During extension exercise, maximum repulsive torque of the normal hand was 2 Nm whereas that of the firm hand was almost 5 Nm. The result revealed that the device was capable enough to not only rotate rigid wrist and fingers with the novel robotic structure, but also present quantitative data such as the repulsive torque according to the joint orientation as an index of joint spasticity level.Improvements/Applications: We are planning to improve the system by applying torque control and arranging experiments at hospitals to obtain patients’ data and feedbacks to meet actual needs in the field.

Comparison Between Neuromuscular Electrical Stimulation to Abdominal and Back Muscles on Postural Balance in Post-stroke Hemiplegic Patients.

ObjectiveTo compare the effects of neuromuscular electrical stimulation (NMES) to abdominal muscles and back muscles on postural balance in post-stroke hemiplegic patients.MethodsThirty post-stroke hemiplegic patients were prospectively enrolled and randomly assigned to one of the three groups: core muscle-strengthening exercise (CME) with NMES to abdominal muscles (group A), CME with NMES to back muscles (group B), and CME alone (group C). All subjects underwent their targeted interventions for 30 minutes each day, 5 days per week for 3 weeks under a conventional stroke rehabilitation program. Subjects were evaluated using Korean version of Berg Balance Scale (K-BBS), Trunk Impairment Scale (TIS), Korean version of Modified Barthel Index (K-MBI), Weight Distribution Index (WDI), and Stability Index (SI) just before and 3 weeks after intervention.ResultsChanges in K-BBS (p<0.05) and TIS (p<0.05) were significantly higher in group A (18.5±8.10, 6.6±1.90) and group B (19.9±5.44, 7.0±2.26) than in group C (8.4±4.14, 3.1±0.99). However, K-MBI, WDI, and SI failed to show any significant difference. No significant difference in all outcomes was observed between groups A and B.ConclusionThe effect of NMES to the abdominal muscles was similar to the effect on back muscles in terms of postural balance. This finding indicated that the NMES to the abdominal muscles may be an alternative for post-stroke hemiplegic patients contraindicated for NMES to the back muscles. Additional studies investigating the effects of NMES on abdominal and back muscles are needed.

Combining Movement-Related Cortical Potentials and Event-Related Desynchronization to Study Movement Preparation and Execution

This study applied a comprehensive electroencephalography (EEG) analysis for movement-related cortical potentials (MRCPs) and event-related desynchronization (ERD) in order to understand movement-related brain activity changes during movement preparation and execution stage of unilateral wrist extension. Thirty-four healthy subjects completed two event-related potential tests in the same sequence. Unilateral wrist extension was involved in both tests as the movement task. Instruction Response Movement (IRM) was a brisk movement response task with visual “go” signal, while Cued Instruction Response Movement (CIRM) added a visual cue contenting the direction information to create a prolonged motor preparation stage. Recorded EEG data were segmented and averaged to show time domain changes and then transformed into time-frequency mapping to show the time-frequency changes. All components were calculated and compared among C3, Cz, and C4 locations. The motor potential appeared bilaterally in both tests' movement execution stages, and Cz had the largest peak value among the investigated locations (p < 0.01). In CIRM, a contingent negative variation (CNV) component presented bilaterally during the movement preparation stage with the largest amplitude at Cz. ERD of the mu rhythm (mu ERD) presented bilateral sensorimotor cortices during movement execution stages in both tests and was the smallest at Cz among the investigated locations. In the movement preparation stage of CIRM, mu ERD presented mainly in the contralateral sensory motor cortex area (C3 and C4 for right and left wrist movements, respectively) and showed significant differences between different locations. EEG changes in the time and time-frequency domains showed different topographical features. Movement execution was controlled bilaterally, while movement preparation was controlled mainly by contralateral sensorimotor cortices. Mu ERD was found to have stronger contra-lateralization features in the movement preparation stage and might be a better indicator for detecting movement intentions. This information could be helpful and might provide comprehensive information for studying movement disorders (such as those in post-stroke hemiplegic patients) or for facilitating the development of neuro-rehabilitation engineering technology such as brain computer interface.

Kinematic Parameters for Changing From Sitting to Standing Position and Gait in Poststroke Hemiparetic Patients

Hemiparetic individuals present changes that negatively affect the functional activities. The purpose of this article is to identify the kinematic parameters in poststroke hemiplegic patients for the duration of changing from the sitting to standing position and then to walking. Sociodemographic and clinical data were collected on the severity of stroke by using the National Institutes of Health Stroke Scale; functional mobility, by the Timed Up and Go test; and the kinematic parameters of changing from the sitting to standing position and then walking by means of the free Computation Vision Mobility software program. There was statistical difference in hip extension associated with ankle dorsiflexion in the final stage of support for walking and dorsiflexion in the beginning (P = .04) and while changing from the sitting to standing position (P = .01), speed (P &lt; .01), cadence (P = .03), and step/stride length (P &lt; .01) of gait. Significant correlations were found between cadence (r 2 = 0.72), speed (r 2 = 0.87), and step/stride length (r 2 = 0.71) and compromised functional mobility. Individuals with hemiparesis after stroke who presented greater ankle dorsiflexion when moving to standing performed a hip extension and dorsiflexion of the ankle in the final support of gait. Individuals who presented this position at this stage of walking had adequate temporal-spatial gait parameters, and these parameters showed significant correlations with impaired functional mobility.

Design of Instrumented Shoes for Gait Characterization: A Usability Study With Healthy and Post-stroke Hemiplegic Individuals.

Ambulation is a fundamental requirement of human beings for enjoying healthy community life. A neurological disorder such as stroke can significantly affect one's gait thereby restricting one's active community participation. To quantify one's gait, spatiotemporal gait parameters are widely used in clinical context with different tests such as 10 meter walk test, 6 min walk test, etc. Though these conventional observation-based methods are powerful, yet they often suffer from subjectivity, a scarcity of adequately trained therapists and frequent clinical visits for assessment. Researchers have been exploring the technology-assisted solutions for gait characterization. There are laboratory-based stereophotogrammetric methods and walk mats that are powerful tools as far as gait characterization is concerned. However, these suffer from issues with portability, accessibility due to high cost, labor-intensiveness, etc. Faced with these issues, our present research tries to investigate and quantify the gait abnormalities in individuals with neurological disorder by using a portable and cost-effective instrumented shoes (ShoesFSR henceforth). The in-house developed ShoesFSR comprised of a pair of shoes instrumented with Force Sensing Resistors (FSR) and a wireless data acquisition unit. The real-time FSR data was acquired wirelessly and analyzed by a central console to offer quantitative indices of one's gait. Studies were conducted with 15 healthy participants and 9 post-stroke survivors. The spatiotemporal gait parameters of healthy participants measured using ShoesFSR were validated with standard methods such as stereophotogrammetric system and paper-based setup. Statistical analysis showed good agreement between the gait parameters measured using ShoesFSR and the standard methods. Specifically, the mean absolute error of the spatial parameters measured by the ShoesFSR, in the worst case, was 1.24% and that for the temporal parameters was 1.12% with that measured by standard methods for healthy gait. This research shows the potential of the ShoesFSR to quantify gait abnormality of post-stroke hemiplegic patients. In turn, the results show a promise for the future clinical use of the ShoesFSR.