title: The difference of gait pattern according to the state of the corticospinal tract in chronic hemiparetic stroke patients.
abstract: OBJECTIVE
  The lateral corticospinal tract (CST) is one of the most important neuronal pathways that mediate voluntary movements in the human brain. However, little is known about the role of the lateral CST on the gait. We attempted to investigate differences in gait pattern using a motion analysis system according to the integrity of the contralateral CST, which was classified using diffusion tensor tractography (DTT) in chronic hemiparetic stroke patients.
  
  
  METHODS
  We recruited 16 chronic hemiparetic stroke patients and 12 normal subjects for this study. DTT findings of the CST for patients were classified into two groups: group A (eight patients); the integrity of the CST was preserved, group B (eight patients) - the CST was discontinued at or below the stroke lesion. We compared variables of gait between group A, group B, and normal controls using the motion analysis system.
  
  
  RESULTS
  Group A and the control group showed a significantly higher peak angle for ankle dorsiflexion, knee internal rotation, and hip flexion, compared with group B (p < 0.05). On the other hand, the peak angle for ankle plantarflexion/external rotation, knee flexion/abduction, and hip extension of group A and group B were significantly lower than those of the control group (p < 0.05).
  
  
  CONCLUSIONS
  We found that severe injury of the contralateral CST caused decreased movement of ankle dorsiflexion, knee internal rotation, and hip flexion in chronic hemiparetic stroke patients. As a result, the circumduction and abduction gait pattern in stroke patients is closely associated with severe injury of the contralateral CST.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
authors.forename: Jeong Pyo
authors.initials: JP
authors.lastname: Seo
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Do
authors.affiliation: Medical Devices Clinical Trial Center, Yeungnam University, Taegu, Republic of Korea Department of Rehabilitation Science, Graduate School, Daegu University, Daegu, Republic of Korea.
authors.forename: Gil Su
authors.initials: GS
authors.lastname: Jung
authors.affiliation: Medical Devices Clinical Trial Center, Yeungnam University, Taegu, Republic of Korea.
authors.forename: Sang Wan
authors.initials: SW
authors.lastname: Seo
authors.affiliation: Department of Physical Therapy, Daegu University, Daegu, Republic of Korea.
authors.forename: Kyoung
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
authors.forename: Su Min
authors.initials: SM
authors.lastname: Son
authors.affiliation: Leaders Rehabilitation Center, Daegu, Republic of Korea.
authors.forename: Yeung Ki
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000843:Ankle Joint; D016022:Case-Control Studies; D002908:Chronic Disease; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006615:Hip / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology*; D011712:Pyramidal Tracts / Q000503:physiopathology*; D016059:Range of Motion, Articular; D020521:Stroke / Q000150:complications / Q000503:physiopathology*
keywords: Corticospinal tract; diffusion tensor imaging; gait; motion analysis; stroke