[3D preliminary analysis gait in stroke patients: knee flexion in compensatory strategies].
OBJECTIVE
The aim of this preliminary study was to assess strategies of walking a stride in stroke patients with spastic right hemiplegia.


METHODS
Gait was recorded in 3D in seven patients without other locomotion disorders. Kinematics data were studied only on the sagittal plane. The position and trajectory markers on the right side were studied during the swing phase in comparison with static standing position. Results were confronted with angular data.


RESULTS
Three walking models were defined: 1) near normal gait with normal mobility in the knee; 2) gait with hicking while the flexion of the knee was reduced; 3) gait with a "talus" foot without motor recovery necessitating a pendular movement.


CONCLUSIONS
The second pathological group was characterized with insufficient flexion in the knee in lifting the foot from the floor. In this group, patients adopted a compensation strategy with hicking in making the stride without touching the floor. We raised the question of limiting this adaptive strategy in order to enhance their remaining mobility.


CONCLUSIONS
A 3D strategy gait analysis, before therapeutic choices, seems to confirm the value of analysing kinematic data in stroke patients with hemiplegia. The amplitude of knee mobility and hip compensation strategy can be specifically studied to improve the effectiveness of therapeutic strategies (orthesis, selective tibial neurotomy, botulinum toxin).
Laborde
A
A
Service de rééducation et de réadaptations fonctionnelles, hôpital Henry-Gabrielle, hospices civils de Lyon, route de Vourles, BP 57, 69565 cedex, Saint-Genis-Laval, France. alexandre.laborde@chu-lyon.fr <alexandre.laborde@chu-lyon.fr>
Caillet
F
F
Eyssette
M
M
Boisson
D
D
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007717:Knee / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology; D020521:Stroke / Q000150:complications / Q000503:physiopathology*