Indices of Loading and Propulsive Ability in the Gait of Patients With Chronic Stroke With Equinus Foot Deviation: A Correlation Study

Abstract

In literature, indices of overall walking ability that are based on ground reaction forces have been proposed because of their ease of administration with patients. In this study, we analyzed the correlation between the indices of dynamic loading and propulsion ability of 40 chronic hemiparetic post-stroke patients with equinus foot deviation and a set of clinical assessments of ankle joint deviations and walking ability. Ankle passive and active range of motion (ROM) and triceps surae spasticity were considered, along with walking speed and three complementary scales of walking ability focusing respectively on the need for assistance on functional mobility, including balance and transfers, and the limitation in social participation. The correlation between the ground reaction force-based indices and both clinical and functional variables was carried out using the non-parametric Spearman correlation coefficient. Both indices were correlated to 8 of the 10 investigated variables, thus supporting their use. In particular, the dynamic propulsive ability was correlated with all functional scales (rho = 0.5, p < 0.01), and has the advantage of being a continuous variable. Among clinical assessments, limited ankle ROM affected walking ability the most, while spasticity did not. Since the acquisition of ground reaction forces does not require any patient prepping, the derived indices can be used during the rehabilitation period to quickly detect small improvements that, over time, might lead to the broad changes detectable by clinical scales, as well as to immediately highlight the lack of these improvements, thus suggesting adjustments to the ongoing rehabilitation approach.

Proprioceptive Exercises in Hemiplegia Improve Balance and Spatiotemporal Parameters

“…In the literature, TUG and BERG tests [14,[24][25][26] for balance assessment in hemiplegia patients, MAS scoring [27] for spasticity assessment, MMSE [28] for mental status, and RMI [29] for functional status are frequently used. To determine the efficacy of the treatments, the parameters were evaluated with pre-test and posttests.…”

Evaluation methods to assess the efficacy of equinovarus foot surgery on the gait of post-stroke hemiplegic patients: A literature review

“…Recently, a study by Mazzoli et al ( 54 ) showed a good correlation between indices based on ground reaction force and clinical and functional variables. Since the acquisition of ground reaction forces does not require patient preparation, it can be used in clinical routine and especially for postoperative evaluation ( 79 ). An alternative is to use combined accelerometric and gyroscopic data on an inertial measurement unit (IMU).…”