title: Locomotor Trajectories of Stroke Patients during Oriented Gait and Turning.
abstract: BACKGROUND
  The Timed Up and Go (TUG) test is widely used to assess locomotion in patients with stroke and is considered to predict the risk of falls. The analysis of locomotor trajectories during the TUG appears pertinent in stroke patients. The aims of this study were i) to analyze locomotor trajectories in patients with stroke during the walking and turning sub-tasks of the TUG, and to compare them with healthy subjects, ii) to determine whether trajectory parameters provide additional information to that provided by the conventional measure (performance time), iii) to compare the trajectory parameters of fallers and non-fallers with stroke and of patients with right and left hemisphere stroke, and iv) to evaluate correlations between trajectory parameters and Berg Balance Scale scores.
  
  
  METHODS
  29 patients with stroke (mean age 54.2±12.2 years, 18 men, 8 fallers) and 25 healthy subjects (mean age 51.6±8.7 years, 11 men) underwent three-dimensional analysis of the TUG. The trajectory of the center of mass was analyzed by calculation of the global trajectory length, Hausdorff distance and Dynamic Time Warping. The parameters were compared with a reference trajectory during the total task and each sub-task (Go, Turn, Return) of the TUG.
  
  
  RESULTS
  Values of trajectory parameters were significantly higher for the stroke group during the total TUG and the Go and Turn sub-tasks (p<0.05). Moreover, logistic regression indicated that these parameters better discriminated stroke patients and healthy subjects than the conventional timed performance during the Go sub-task. In addition, fallers were distinguished by higher Dynamic Time Warping during the Go (p<0.05). There were no differences between patients with right and left hemisphere stroke.
  
  
  CONCLUSIONS
  The trajectories of the stroke patients were longer and more deviated during the turn and the preceding phase. Trajectory parameters provided additional information to timed performance of this locomotor task. Focusing rehabilitation programs on lead-up to turn and turning could be relevant for stroke patients since the Turn was related to the balance and the phase preceding the turn seemed to distinguish fallers.
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, APHP Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Bonnyaud
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, APHP Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Roche
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, APHP Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Angele
authors.initials: A
authors.lastname: Van Hamme
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, APHP Service de Médecine Physique et Réadaptation, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Djamel
authors.initials: D
authors.lastname: Bensmail
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, APHP Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Pradon
mesh_terms: D000058:Accidental Falls; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance; D018570:Risk Assessment; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016138:Walking