Stroke Gait Kinematic Characteristics in Response to Balance Impairments via Principal Component Analysis

Research Objectives: To investigate the relationship between joint kinematics and Burg Balance Score in patients with stroke.

Design: Cross-sectional observational study

Setting: Rehabilitation hospital and research laboratory

Participants: 44 chronic post-stroke included in gait assessment and data analysis.

Interventions: Not applicable

Main Outcome Measures: Clinical assessments including balance impairments and joint kinematics during gait

Results: Of the 44 subjects, 14 (31.8%) exhibited balance impairment and were assigned to the Berg balance score (BBS) low group ( < 45). Significant differences were observed in range of motion of ankle dorsiflexion, isometric contraction force of ankle dorsiflexor and ankle invertor, BBS, timed up and go, fall efficacy scale, mini-mental state estimation, walking speed, double support time, nonparetic stance time, nonparetic step length, and paretic step length between the groups (p < 0.05). Reconstructed average joint kinematics during gait, using the significant principal component score of principal component vectors, showed that BBS low group exhibited smaller paretic ankle dorsiflexion during the stance phases, a smaller paretic knee flexion, particularly during the swing phase, and a more flexed hip joint during the entire gait cycle compared with the BBS high group (≥45) (Table.1). Moreover, their pelvic joints tended to posterior tilt during the entire gait cycle compared with the BBS high group. Furthermore, the distribution of standard deviations on the nonparetic side was significantly larger than that on the paretic side in both the frontal and horizontal planes.

Conclusions: The kinematic differences in BBS groups were particularly observed in the sagittal planes. This study provides a more comprehensive understanding of stroke hemiparetic gait patterns in terms to balance impairments. Principal component analysis can be a useful tool to assess differences in balance impairment and dynamic symmetry during gait in patients with stroke.

Author(s) Disclosures: The authors declare no competing interests.