Gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery.
OBJECTIVE
Gait patterns vary among stroke patients. This study attempted to discover gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery.


METHODS
Data were gathered from 35 stroke patients and 15 healthy subjects. Gait performance and motor recovery were assessed 6 mos after stroke. Stroke patients further were divided into poor and good groups. The walking velocity was correlated with Brunnström's stages, and the temporal stride and motion variables of the two groups were compared.


RESULTS
Walking velocity was positively correlated with the Brunnström's stages of the proximal lower limb. The poor group displayed slower walking velocity and shorter single-support time compared with the good group. Both groups displayed low maximum excursion of hip extension and ankle plantarflexion during the stance phase and low maximum excursion of hip and knee flexion and ankle dorsiflexion during the swing phase. Moreover, both groups displayed excessive pelvic tilts during the stance and swing phases. However, the poor group displayed different pelvic motion and timing sequences to each peak joint angle from normal subjects and the good group. Peak hip and knee angles of the affected limb during the stance phase occurred almost simultaneously in this group.


CONCLUSIONS
Selective control of the proximal lower limb may be the main determinant of walking velocity. The compensatory adaptations were similar, except for pelvic motion, in stroke patients with different levels of motor recovery, whereas the poor group walked with synergistic mass patterns and reduced stability.
Chen
Chia-Ling
CL
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial and Children's Hospital, Taipei, Taiwan.
Chen
Hsieh-Ching
HC
Tang
Simon Fu-Tan
SF
Wu
Ching-Yi
CY
Cheng
Pao-Tsai
PT
Hong
Wei-Hsien
WH
D000222:Adaptation, Physiological; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation