Typical Changes in Gait Biomechanics in Patients with Subacute Ischemic Stroke.

Background/

Objectives

Gait dysfunction occurs in 80% of stroke survivors. It increases the risk of falls, reduces functional independence, and thus affects the quality of life. Therefore, it is very important to restore the gait function in post-stroke survivors. The purpose of this study was to investigate the functional changes of gait biomechanics in patients with hemiplegia in the subacute stage of ischemic stroke based on spatiotemporal, kinematic, and EMG parameters.

Methods

Initial biomechanical gait analyses of 31 patients and 34 controls were selected. The obtained parameters were assessed and compared within and across the study groups (post-stroke hemiparetic patients and healthy controls) to determine the pathognomonic features of the hemiplegic gait.

Results

The gait function asymmetry was characterized by reciprocal changes, i.e., harmonic sequences of gait cycles. The most significant changes were in the kinematics of the knee joint and the EMG activity in the anterior tibialis, gastrocnemius, and hamstring muscles on the paretic side. The movements in the lower extremity joints ranged from a typical amplitude decrease to an almost complete lack of movement or involuntary excessive movement, as can occur in the ankle joint. The knee joint showed two distinct patterns: a slight flexion throughout the entire gait cycle and knee hyperextension during the middle stance phase.

Conclusions

The gait function asymmetry is characterized by reciprocal changes (in temporal gait parameters). The most significant changes included decreased amplitude in the knee joint and decreased amplitude of EMG of all muscles under study, except for the m. quadriceps femoris.