Asymmetry and Variability Should Be Included in the Assessment of Gait Function in Poststroke Hemiplegia With Independent Ambulation During Early Rehabilitation

Abstract

Objective: To extract independent features from spatiotemporal data of poststroke gait. Design: Retrospective observational study. Setting: Motion analysis laboratory in the rehabilitation department of a university hospital. Participants: Convenience sample from inpatients in subacute recovery stage post stroke. Of 98 patients post stroke who underwent gait assessment, 69 patients post stroke were included in the data analysis (N=69). They could walk more than 10 m without personal assist or assistive devices. Interventions: Not applicable. Main Outcome Measures: Spatiotemporal parameters during level walking and their asymmetry and variability were obtained by insole foot pressure measurement system. Results: Of independent components extracted by principal component analysis, 3 independent components explained 81.9% of total variance of spatiotemporal poststroke gait data. The first component has associations with walking speed and proportion of double support phase, and it explains 46.6% of total variance. The second component has association with temporal asymmetry, and it explains 21.1% of total variance. The third component has association with temporal variability, and it explains 14.2% of total variance. Principal component scores did not show significant differences between stroke types and among stroke lesions. Conclusions: Temporal asymmetry and variability should be included in the assessment of poststroke gait during early rehabilitation. They are independent of each other and provide characteristics of poststroke gait that are independent to the walking speed. They are helpful for rehabilitation planning and developing treatment strategy in poststroke gait rehabilitation. (C) 2020 by the American Congress of Rehabilitation Medicine