Task-Based Mapping of Compensatory Strategies and Movement Kinematics After Stroke: A Systematic Scoping Review.

Although compensatory motor strategies are widely described after stroke, there is still no structured synthesis integrating their kinematic characteristics across core functional tasks. This scoping review aimed to map compensatory strategies and movement kinematics in mobility, postural control, and upper-limb tasks after stroke. The review followed the Joanna Briggs Institute methodology and was registered on the Open Science Framework. Ten databases were searched through August 2024. Studies including individuals post-stroke that used motion analysis to characterize compensatory strategies during sit-to-stand and stand-to-sit transfers, gait, step up/down, postural control, and upper-limb tasks (reaching, grasping, and manipulation) were included. Compensatory strategies were defined as alternative task-oriented motor patterns involving redistribution of movement to preserved segments or substitution of impaired motor elements to maintain functional performance. Movement kinematics comprised spatiotemporal parameters and joint-level kinematic variables derived from motion analysis. Data were extracted and synthesized according to task category. A total of 101 studies were included. In mobility tasks, the most frequently reported compensatory strategies involved asymmetrical weight-bearing, reduced step length and cadence, prolonged movement time, and reduced joint excursion at the hip, knee, and ankle. During postural control tasks, common findings included weight-bearing asymmetry, increased mediolateral displacement of the center of pressure, and reduced weight-shifting capacity. In upper-limb tasks, compensatory patterns were characterized by prolonged movement time, reduced elbow extension, and increased trunk and shoulder contribution. In conclusion, this review provides a structured task-based mapping of compensatory motor behavior and its associated kinematic parameters in individuals after stroke.