Quantification of Lower Extremity Dressing Movements in Patients With Stroke.

OBJECTIVE

To quantify movement characteristics of lower extremity dressing among patients with stroke.

DESIGN

Retrospective study.

SETTING

Rehabilitation hospital.

PARTICIPANTS

This study included 49 patients with stroke and hemiplegia. They were classified by toileting scores of the Functional Independence Measure: independent group (14 men, 4 women; n=18), supervision group (13 men, 3 women; n=16), and assistance group (11 men, 4 women; n=15).

INTERVENTIONS: None.

MAIN OUTCOME MEASURES: The lower garment raising movement was measured using a 3-dimensional motion analysis system. Forty-three reflective markers were attached, and the movement was divided into 5 phases based on hand-marker trajectories. Trunk and pelvic angles, center-of-pressure range, paretic limb loading ratio, manipulation time, and vertical displacement of the lower garment were calculated.

RESULTS

The supervision group had longer manipulation times than the independent group during the downward reach (2.08s vs 1.29s, P=.005) and the first paretic-side manipulation (1.28s vs 0.66s, P=.013). The assistance group exhibited smaller pelvic flexion during the downward reach (3.38° vs 8.42°, P=.002), as well as showed smaller trunk rotation angle (-11.05° vs 3.46°, P=.002) and pelvic rotation angle (-6.32° vs 5.28°, P=.013) than the supervision group during the final non-paretic-side manipulation, and performed the task while oriented toward the paretic side. Furthermore, during the final paretic-side manipulation, the assistance group exhibited a significantly larger pelvic rotation angle (18.29° vs 9.50°, P=.009).

CONCLUSIONS

In the supervision group, decreased efficiency was noted during the downward reach and initial manipulations. In the assistance group, participants performed downward reach and the final manipulations in a posture that limited hand access to the lower garment, resulting in inefficient movements.